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Lasik Self-Evaluation Test

Find out if you are a LASIK candidate! Take our Self-Evaluation Test online and you will be notified by our LASIK Coordinator to discuss your candidacy. If you are a preliminary candidate you will be invited to schedule a FREE LASIK EVALUATION with Dr. George Frangieh at Boston’s Premiere LASIK Center, Eye Care Specialists.

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Please answer these quick questions about your vision to help us understand your needs. Thank you.

1) Do you have trouble seeing far away or up close? (required)
 Up Close Far Away

2) How interested are you in being able to be active or play sports without glasses and contacts? (required)
 It’s very important to me NOT to wear glasses for activities such as sports. It’s not important to me. I do not mind wearing glasses.

3) What is your age? (required)
 Under 21 21-40 41-55 56-69 70+

4) Are you interested in seeing well up close (reading) without glasses? (required)
 It’s very important to me NOT to wear reading glasses. It’s not important to me. I do not mind wearing reading glasses to see things up close.

5) Do you wear contact lenses or glasses? (required)
 Glasses Contact Lenses Both

6) Would your career or business activities improve if you were to become less dependent on glasses and contacts?
 Yes No Maybe

7) Over 98% of LASIK patients see 20/40 or better after surgery. The results of LASIK laser vision correction have been tremendous for literally millions of people. Despite the amazing safety and results of this procedure there are associated risks. Are you willing to discuss these risks with our LASIK coordinator?
 Yes No

8)And finally, How did you hear about Dr. Frangieh and Eye Care Specialists LASIK Vision Correction Surgery? (required)
 Referral from a Doctor Referral from Family/Friend Facebook Post/Ad Twitter Post Yelp.com Google Search Angie's List Dunkin Perks TV/Radio Email Newsletter Postcard

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