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Find out if you are a good candidate for laser vision correction

 
 

Answering these questions will help us determine if you are a good candidate for laser correction.

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Gender
How old are you?


You have trouble seeing: *



Do you have astigmatism? *

You wear: *


Has your diopter changed in the past year? *

If you are a good candidate, when you would like to have surgery? *



Do you have any of these eye diseases? *








Do you have any of these systemic illnesses?




Are you pregnant? *
Do you breastfeed? *
What is the main reason why you want the laser vision correction? *




How did you find out about us?






Name and surname: Molimo unesite ime i prezime!

Date of birth: Molimo unesite datum i godinu rođenja!

Phone: Molimo unesite broj telefona!

City: Molimo unesite grad!

E-mail: Molimo unesite e-mail adresu!
 
 
 
 
 
 
 
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