MN Eye Institute :: Free Consultation

First & Last Name *

Date of Birth *

Phone Number *

Email Address

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Current Healthcare Problems *

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Any Allergies *

Any eye injuries or surgeries in the past? *

Do you wear contact lenses? *

Yes

No

If YES, what type?

Soft

Gas-Permeable

Hard (non-porous)

Do you wear contact lenses while sleeping?

Yes

No

How many years have you worn contact lenses?

When did you last wear them

You must stop wearing soft contact lenses at least one week prior to your LASIK pre-operative exam. Hard lenses (including gas-permeable hard lenses) must not be worn for at lease one month prior to your exam. Failure to follow these guidelines may cause inaccurate pre-op measurements and poor LASIK results. If you have not stopped wearing your lenses for these periods, please inform us and we will help you reschedule your pre-op exam.

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Minnesota Eye Institute, Lasik Eye Surgery in Alexandria, MN

Call 877-536-2020 for a free LASIK Screening!

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