COVID-19: How we're taking precautions.
Hampton
1613 Hardy Cash Drive
Hampton, VA 23666
2200 Executive Dr, Suite A
Hampton, VA 23666
Williamsburg
5215 Monticello Ave
Williamsburg, VA 23188
Request an Appointment
Pre-Register Now
Pay Online
757-229-4000
Home
About Us
Our Doctors
Surgery Center
Services
Cataract
Cataract Surgery
Femtosecond Laser Assisted Cataract Surgery (FLACS)
Cataract FAQs
Advanced Technology Implants
Artificial Lens Implant FAQ
Toric IOL
Multifocal Lens Implants
Tecnis Symfony & Symfony Toric IOL
Astigmatism Reduction
Cataract Self Test
LASIK
LASIK Eye Surgery
PRK Surgery
Refractive Lens Exchange
LASIK FAQs
Are You a Candidate?
LASIK Self-Test
Glaucoma
Glaucoma Surgery
General Eye Care
Cosmetics
Diabetic Evaluation and Care
Dry Eye Treatment
Eyelid Surgery
Retina Services
Optical Boutique
Patient Information
Media Center
Patient Financing
Patient Forms
New Patient Forms
Established Patients
Cataract Surgery Forms
Cosmetic Forms
Records Release Forms
Patients Just Like You
Office Policies
Contact Us
Locations
Hampton
Williamsburg
Request an Appointment
Pay Online
Pre-Register Now
LASIK Self-Test
Home
/
LASIK
/
LASIK Self-Test
LASIK Self-test
Name
Phone
Email
Do you have trouble seeing far away or up close?
Select Your Answer
Up Close
Far Away
2. How interested are you in being able to play sports without glasses and contacts?
Select Your Answer
It is very important to me NOT to wear glasses for activities such as sports.
It is not important to me. I do not mind wearing glasses.
3. What is your age?
Select Your Answer
Under 21
21-40
40-69
69+
4. Are you interested in seeing well up close (reading) without glasses?
Select Your Answer
It is very important to me NOT to wear reading glasses.
It is not important to me. I do not mind wearing reading glasses to see things up close.
5. Do you wear contact lenses or glasses?
Select Your Answer
Glasses
Contact lenses
6. Would your career or business activities improve if you were to become less dependent on glasses and contacts?
Select Your Answer
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?
Select Your Answer
Yes
No
-
+
LASIK
LASIK Eye Surgery
PRK Surgery
Refractive Lens Exchange
LASIK FAQs
Are You a Candidate?
LASIK Self-Test
Request an Appointment
Cataract Self-Test
Patient Financing