accessibility ACCESSIBILITY
Is LASIK right for you?

Thank you for visiting Modesto Eye Center webpage.  The following questions are very basic and are only a small part of what we use to fully assess someone as a candidate for iLASIK procedure.  A full examination by a medical doctor is necessary to determine your candidacy. 

1. Age Group





2. Are you




3. Do you wear




4. Do you need reading glasses?



5. Have you ever had eye surgery?



6. Are you in good general health?



7. What is your intereset in LASIK (mark all that apply)?







Please provide us with your contact information:

First Name:  
Last Name:  
Email Address:  
Phone: