LASIK Laser Eye Surgery & Vision Correction Center, Texas Surgeon & Doctor - Key-Whitman Eye Center
Key-Whitman Eye Center, leader in LASIK, Intralase, Crystalens, ReStor, ReZoom, Cataract surgery
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Four locations to serve you Dallas, Plano, North Arlington and South Arlington. Phones Answered:
Monday - Friday, 7:45AM - 9:00PM & Saturday and Sundays, 11:00AM - 5:00 PM.
Give us a call today at 888-215-1999. Dénos una llamada hoy a 214-473-5125
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Home  >  Self Evaluation Form


Wondering if you may be a candidate for LASIK or another type of laser vision correction? Take our quick 1-minute self-evaluation to determine your vision correction options:
 
1. What is your age range?
 
2. Which do you use most frequently?
 

3. Do you have trouble seeing far-away or up-close? Check all that apply.
 
4. Do you have or suspect you have any of the following? Check all that apply.
 

5. Do you know your prescription today?  If so, please list below:
Left eye:
Right eye:

(for example -2.75 or +3.25)
 
6. Which is the most important issue for you regarding your vision correction procedure?
 
7. If you were determined to be a good candidate, how soon would you like to have your procedure?
 

Your preliminary results will be posted online immediately and your profile will be sent to our vision counselors to clarify any points that need more information and to discuss your specific situation.


*First Name:
*Last Name:
*Email:
Phone:
   
 

Disclaimer: This survey does not replace an in-office exam, nor is it designed to provide online consultation. The information is intended for information purposes only and will help guide you to appropriate vision correction treatment(s) among the various procedures we offer today. It is not a determination for candidacy which can only be made through a thorough in-office examination and consultation.
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Key-Whitman Eye Center - Cataract & LASIK/Laser eye surgery by our eye surgeons can help in vision correction. The cost for LASIK at our eye care center is usually less than any reputable competitor in this market.