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Russell E. Swann, MD, FACS
Forrest Beau, MD, MS
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LASIK Self Evaluation Test
LASIK Self-Test
Name
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First
Last
Phone
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Email
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Do You Have Trouble Seeing Far Away Or Up Close?
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Up Close
Far Away
How Interested Are You In Being Able To Play Sports Without Glasses And Contacts?
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A Lot
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What Is Your Age Range?
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20s
30s
40s
50+
Are You Interested In Seeing Well Up Close (reading) Without Glasses?
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Yes
No
Do You Wear Glasses Or Contact Lenses?
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