You + LASIK = Match made in heaven? In a few minutes, you’ll have a better idea about whether you and LASIK are soulmates. No one wants sub-par vision, but for various reasons, LASIK isn't for everyone. Let's find out! So take the drop and cruise through this quiz to get the clearest picture. (See what we did there with that ‘clear’ thing? We’re suckers for vision jokes.) Step 1 of 4 25% How serious are you about getting LASIK?*I've done my homework and am ready to go!I know I want LASIK, but I need more info about the process.I want better vision, but I'm not sure if LASIK is the best option for me.How old are you?*0-1920-2930-3940-4950-5960+Gender*MaleFemaleHow's your night vision?*GreatAverage, I thinkPretty badWithout vision assistance (glasses, contacts, etc)...*Select all that apply I can't see very far away (nearsighted/myopia) I can't read very well (farsighted/hyperopia) I may have astigmatism (images distorted) Do you ever use vision assistance items?*Select all that apply Glasses Contacts Other No Which type of glasses?*Select all that apply Everyday Use Reading Bifocals / Trifocals Other Which type of contacts?*Select all that apply Soft Hard What 'other' vision assistance item(s) do you use?*Aside from glasses, what 'other' vision assistance item(s) do you use?*Aside from contacts, what 'other' vision assistance item(s) do you use?*Aside from glasses & contacts, what 'other' vision assistance item(s) do you use?* How dependent on glasses, contacts, or other vision assistance items are you? (10 = most)*Please enter a value between 1 and 10.How much additional time do you spend each day (on average) due to poor vision?*Dealing with contacts, glasses, special accessories, etc. (Purchasing, cleaning, finding lost items, repairing, new prescription appointments, etc.)Less than 3 mins3-5 mins6-9 mins10-15 mins15-20 mins20+ minsDo you know your prescription?*Yes, for both eyesLeft eye onlyRight eye onlyNoPrescription - Left Eye*What was your most recent glasses or contacts prescription? (-1.5, -3, or +2, etc)Prescription - Right Eye*What was your most recent glasses or contacts prescription? (-1.5, -3, or +2, etc)Has your vision (prescription) changed within the past 2 years?*YesNoI'm not sure Have you ever had eye surgery?*YesNoDo you have any concerns?* Is it worth it? How long before I’m back to normal? Risks outweigh benefits? Doctor experienced enough? Can I afford it? Other No concerns, let's do this If you’re a ‘candidate’ (vision conditions are a match), what’s your ideal timeframe for getting LASIK?*Yesterday1 Month2-6 Months6+ MonthsHave you ever had a professional in-office LASIK evaluation?*YesNoDo you want to setup a free LASIK evaluation at our office?*YesMaybe, I'd like more infoNoWhat questions, concerns, or comments do you have? Which contact methods are acceptable?*Select all that apply Phone Email Text Your Mobile Phone #*Your Email* Enter Email Confirm Email What's your name so we know who to address?* First Last PhoneThis field is for validation purposes and should be left unchanged.