512.
472.4011
Home
Meet Our Team
Zarmeena Vendal, M.D.
Natalie Stanciu, M.D.
Stanley Saulny, M.D.
Catherine Makin, M.D.
Andrew Plummer, M.D.
Liana Renteria, O.D.
Austin Ophthalmologists
Eye Care Services
LASIK Eye Surgery Center
LASIK Alternatives
LASIK Self-Test
LASIK Pricing
PRELEX®
Cataract Center
Laser Cataract Surgery
Premium Lens Implants
Premium Lens Self-Test
Glaucoma Center
Cornea Center
Pterygium and Conjunctival Chalasis
Dry Eye Center
PROKERA® and PRP for Dry Eyes
LipiFlow® and TearCare
IPL Therapy
Plastics Center
Ptosis
BOTOX®
Blepharoplasty
Cosmetic IPL Therapy
Eye Care Center
Eye Health
Common Eye Disorders
Diabetic Eye Exams
Ocular Allergies
Pterygium
Patient Information
Patient Information
Insurance & Financing
Testimonials
Notice of Nondiscrimination
Patient Portal
Blog
Podcasts
Contact Us
Locations
Austin Clinic
Kyle Location
New Braunfels Clinic
LASIK Self-Test
Home
»
LASIK Eye Surgery Center
»
LASIK Self-Test
LASIK Eye Surgery Center
LASIK Alternatives
PRELEX®
LASIK Self-Test
Font Re-Sizer
Step
1
of
9
11%
First Name
(Required)
Last Name
(Required)
Phone
(Required)
Email
Can We Text You?
(Required)
Yes
No
What is your age group?
Under 18
19-39
40-59
60+
Without my glasses and contacts... (check all that apply)
Farsightedness: I have trouble reading and seeing things up close
Nearsightedness: I have trouble driving and seeing things far away
Astigmatism: I have distorted vision and cannot see very well
What do you usually wear? (check all that apply)
(Required)
Glasses
Contacts
Reading Glasses
None of Them
Do you have any of the following? (check all that apply)
(Required)
Rheumatoid Arthritis
Multiple Sclerosis
Lupus
Cataracts
Keratoconus
Diabetic Retinopathy
Prior Eye Surgery
Prior serious eye injury
Are you pregnant or nursing?
None of the above
I would like to see well at a distance without relying on glasses and contact lenses.
Rate this statement on a scale of 1 to 5 with 1 being the lowest.
(Required)
1
2
3
4
5
I would like to see well up close without relying on glasses and contact lenses.
Rate this statement on a scale of 1 to 5, with 1 being the lowest.
(Required)
1
2
3
4
5
Would your lifestyle improve if you were to become less dependent on glasses and contact lenses?
Would your lifestyle improve if you were to become less dependent on glasses and contact lenses?
(Required)
Yes
No
Would you like to speak with our Laser Vision Correction Team?
I'm ready to book my consultation!
Yes, please call me to discuss my options.
I'm not ready yet
Verification
Share
Tweet
0
Shares
Request an Appointment
Contact Us
Patient Portal
Premium Lens Self-Test
Online Bill Pay
Patient Portal
.png)