1. What is your age group? 2. What do you usually wear? (Check All that Apply) 3. Recognizing that LASIK is not normally covered by insurance, Medicaid or Medicare, please let us know your preferred method of payment: 4. Please choose the closest location for your free consultation. 5. Please provide us with your contact information:

By submitting your information you acknowledge that you are genuinely interested in having a LASIK consultation with one of our Advanced Vision Network practices.
I understand and agree to be contacted by phone for additional questions to further qualify my LASIK candidacy before giving my information to a practice in the Advanced Vision Network.