LASEK Questionnaire












Up Close
Far Away



It's very important to me NOT to wear glasses for activities such as sports.
It's not important to me. I do not mind wearing glasses.



Under 21
21-40
40-69
69+



It's very important to me NOT to wear reading glasses.
It's not important to me. I do not mind wearing reading glasses to see things up close.



Glasses
Contact lenses



Yes
No
Maybe



Yes
No






Have questions? Contact lasik@boozmanhof.com