
WELCOME TO OUR LASIK SELF TEST
First things first
How old are you?



QUESTION 2:
DO YOU WEAR...

QUESTION 3:
WITHOUT WEARING EYEGLASSES/ LENSES, DO YOU HAVE...

QUESTION 4:
Have you been diagnosed with Astigmatism?


QUESTION 5:
WHAT EMAIL SHOULD WE SEND THE RESULTS TO?


QUESTION 6:
WHAT IS YOUR FIRST NAME?


QUESTION 7:
WHAT IS YOUR LAST NAME?


QUESTION 8 (Last question!):
On which phone number would you like us to contact you?