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WEBINAR ON-DEMAND
START FREE SELF TEST
PRICING REQUEST
VIDEO FAQ
CALL 424-732-2020
Step
1
of
7
14%
Please tell us how old you are
(Required)
Under 18
19-39
40-59
60+
Have you ever been told you have astigmatism?
(Required)
Yes
No
Do you have to wear glasses/contacts for?
(Required)
Driving
Reading
Computer
All of the above
Have you had any of the following procedures on your eyes (LASIK, PRK, RK, Cataract Surgery)?
(Required)
Yes
No
Do you suffer from multiple sclerosis, lupus, keratoconus or diabetic retinopathy?
(Required)
Yes
No
You are not a candidate for RLE surgery but Dr. Hamilton can further evaluate your situation. Our office will reach out to take your insurance information and schedule a medical consultation
To help us follow up with you, please provide your contact details below:
Name
(Required)
First
Last
Phone
(Required)
Email
(Required)
Step
1
of
7
14%
Please tell us how old you are
(Required)
Under 18
19-39
40-59
60+
Have you ever been told you have astigmatism?
(Required)
Yes
No
Do you have to wear glasses/contacts for?
(Required)
Driving
Reading
Computer
All of the above
Have you had any of the following procedures on your eyes (LASIK, PRK, RK, Cataract Surgery)?
(Required)
Yes
No
Do you suffer from multiple sclerosis, lupus, keratoconus or diabetic retinopathy?
(Required)
Yes
No
You are not a candidate for RLE surgery but Dr. Hamilton can further evaluate your situation. Our office will reach out to take your insurance information and schedule a medical consultation
To help us follow up with you, please provide your contact details below:
Name
(Required)
First
Last
Phone
(Required)
Email
(Required)
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WEBINAR ON-DEMAND
START FREE SELF TEST
PRICING REQUEST
VIDEO FAQ
CALL 424-732-2020
