LASIK Self-Test

1. 01 Are you 18 years of age or older?

   Yes No
2. 02 Has your glasses or contact lens prescription been stable for at least a year?

   Yes No
3. 03 Do you wear glasses or contacts to see clearly at a distance?

   Yes No
4. 04 Are your eyes generally healthy, without active infection, injury or disease?

   Yes No
5. 05 Are you free of health conditions that affect healing, such as uncontrolled diabetes or an autoimmune disorder?

   Yes No
6. 06 Are you not currently pregnant or nursing?

   Yes No
7. 07 Do glasses or contacts get in the way of your work, sports or daily life?

   Yes No
8. 08 Would you like to reduce your dependence on glasses and contact lenses?

   Yes No

This self-test is for general information only and is not a diagnosis. Your answers stay on this page — nothing is sent or saved.