2353 Alexandria Drive, Lexington, KY
(859) 224-2655 
Did You Know:  Commonwealth Eye Surgery was the first practice in Kentucky to implement the 100 Hz with Advanced Personalized Technology upgrade to our Bausch & Lomb Technolas 217z laser system, as well as, the first in the state to implement the ORange Intraoperative Aberrometry system used in cataract surgery

Do I Qualify for LASIK?

The only accurate way to know if LASIK eye surgery is right for you is to have have a LASIK consultation at our office, but this quick self evaluation will give you an idea if you might be a candidate. Complete the form below and a LASIK specialist will contact you with the results.

LASIK Qualification Questionnaire

Fill out the following form to see if you qualify.

Your Name (required):

Your Email (required):

Phone Number (required):

Are you in good general health?
 Yes No

Do you wear glasses or contacts most of the time?
 Glasses Contacts

How would you rate your quality of night vision?
 Good Fair Poor

Do you currently wear reading glasses?
 Yes No

Which is the most important issue for you regarding LASIK?
 Outcome Affordability Being free of my glasses or contacts

Do you have any apprehensions or confusions about LASIK?
 Yes Possibly No

Are you aware of the technical benefits of LASIK?
 Yes No

Do you have any of the following?
 Myopia (Nearvision) Hyperopia (Farvision) Astigmatism

How did you hear about us?

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