Free Consultation for Laser Vision Correction- Vision Surgery & Laser Center of Indiana

:: Free LASIK Consultation

:: Our LASIK Surgeons and Directions	:: Practice Services
:: LASIK Laser Vision Correction	:: Am I A LASIK Candidate?
:: Custom Wavefront LASIK	:: LASIK Fees and Payment Options
:: LADARVision® Technology	:: Free LASIK Consultation
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502 Marquette Street
Valparaiso, Indiana 46383

1-866-522-EYES

We can help you determine if LASIK Laser Vision Correction
is right for you. It is our pleasure to provide you with a
Free* Consultation.
Schedule your Free Consultation Today!

Vision Surgery & Laser Center of Indiana
is dedicated to providing you with individualized and personalized LASIK education and care at every step of the process in order to make certain that you receive the best care and achieve your personal goals.

Vision Surgery & Laser Center of Indiana has arranged to provide you with a
FREE Consultation Today!

Please complete the following form (ALL Fields are required items*)

First Name:*

Last Name:*

Address:*

City:*

State:*

Zip:*

Phone:*

E-mail:*

Please Answer The Following Questions

I wear

Glasses Contact Lenses
Bi focals / Reading glasses

I wear my glasses and/or contact lenses to see

Distance Near Both Distance and Near

I am interested in having Laser Vision Correction within

the next month 6 months

3 months 12 months

Please Indicate Your Acceptance.

Please contact me to schedule a

Complimentary Consultation
A Treatment Date

Please contact me regarding

Corporate Benefit Programs
An affordable payment plan

Please include me in further informational mailings

Please select the best time to be reached by our Refractive Surgery Coordinator:

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*(see important note)