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Best Lasik Services!

Jun 19, 2020

Best Boulder Lasik Award 2019

Recent Posts

LASIK Eye Surgery Explained
Aging at Altitude virtual expo – now through May 31
Caring for your Eyes in Cold Weather
Increased Eye Strain Concerns in Children from Screen Time
Welcome Dr. Melissa Burton

BOULDER

3000 Center Green Drive
Suite 250
Boulder, CO 80301

Phone: (303) 772-3300
Fax: (303) 682-3380

LAFAYETTE

300 Exempla Circle
Suite 120
Lafayette, CO 80026
(Located within Exempla Community Physicians Pavilion)

Phone: (303) 772-3300
Fax: (303) 682-3380

LONGMONT

1400 Dry Creek Drive
Longmont, CO 80503

Phone: (303) 772-3300
Fax: (303) 682-3380

GREELEY

1616 15th Street
Greeley, CO 80634
(Located within Welch Eye Clinic)

Phone: (303) 772-3300
Fax: (303) 682-3380

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Step 1 of 7

14%

What is your age range?*
- Under 18
- 18 - 39
- 40 - 49
- 50+

Without my glasses and contacts...*
check all that apply
- I struggle to drive and see things far away‎ (Nearsighted)
- I struggle to read and see things up close (Farsighted)
- I have distorted vision and cannot see very well‎ (Astigmatism)

What do you usually wear to see?*
check all that apply
- Glasses
- Contacts
- Reading Glasses
- Nothing

Do you have any of the following?*
check all that apply
- Prior Eye Surgery‎
- Prior serious eye injury‎
- Rheumatoid Arthritis‎
- Cataracts‎
- Lupus‎
- Keratoconus‎
- Are you pregnant or nursing?‎
- None of the above‎
It would be best to wait until after your baby is born before undertaking one of our surgical procedures.

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.

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.

Looks like you are a great candidate for LASIK!

Please complete the form below so we can setup a consultation!
You may not be a good candidate for Lasik… BUT, we can look at one of our other refractive surgical procedures as an option.

Please complete the form below so we can setup a consultation for your best options!
Name*
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Step 1 of 2

50%

Are you experiencing?
- Clouded, blurred, or dim vision?
- Difficulty seeing distant objects?
- Sensitivity to light or glare?
- Difficulty seeing distant objects?
- Seeing a halo around lights?
- Fading or yellowing of colors?
Has your prescription for eyeglasses changed more often than usual?
- Yes
- No
Do you need brighter light for reading?
- Yes
- No
Does your vision sometimes seem distorted?
- Yes
- No
Have you experienced double vision in one eye only?
- Yes
- No
Do you see “ghost” images?
- Yes
- No
How do you prefer to have a member of our clinic’s staff follow up and contact you?
- Phone
- Email

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