Am I a Candidate?

LASIK is a surgical procedure conducted on a delicate part of the eye called the cornea. As such, it is critical that potential candidates are well educated on the benefits and risks of the procedure. It is imperative to recognize the importance of a thorough examination to maintain realistic expectations about the procedure’s outcome. Most patients who come to us for vision correction are excellent candidates for LASIK surgery. However, Dr. Jenkins may decide that LASIK is not the vision correction option that will give you the best results, and will discuss what your options for vision correction alternatives to LASIK.

CLICK HERE for an informative piece on decision making with vision correction and some FAQs on whether or not LASIK is indeed for you!

Your Age (required)

Do you Suffer From (check all that apply)
Nearsightedness(I can't see objects clearly that are far away)‎Farsightedness(I can't see objects clearly that are close)‎Astigmatism‎

Do you know your prescription?
+5 to 00 to -55 to -10-10 or higherI don't know

Has your prescription been stable for the last year?
YesNoI don't know

What type of eyewear do you use now? (check all that apply)
Eyeglasses Only‎Soft Contact Lenses Only‎Both Eyeglasses and Soft Contact Lenses‎Soft Toric Contact Lenses‎Gas Permeable Rigid Contact Lenses‎None of the Above‎

Do you wear reading glasses or bifocals?
Yes, Reading GlassesYes, Bifocals‎No‎

Have you ever had an eye injury or eye surgery?
YesNo

What has kept you from having LASIK in the past?

How did you hear about us?

Please provide us with your contact information and we will e-mail you your detailed results.
The answers to these questions will give us a general guideline as to your candidacy and expected outcome, the results of which we will provide. However, this short questionnaire is NOT a substitute for a proper medical examination and is simply a guide to help you work out if LASIK should be on your ‘to do’ list. The only way to know if LASIK is right for your eyes is to have a thorough LASIK Medical Examination.

Name

Your Email

Your Phone

We will contact you via email with the results.

If you are a candidate would you like us to contact you to schedule your free consultation?
Yes, call me at the number providedPlease email me more informationNo