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Step 1 of 6 - Step One

16%
I most often wear:*
What is your age range?*
I've been told I have astigmatism*
Without my glasses I have trouble reading street signs*
Without my contacts I have trouble reading street signs*
Without my readers I have trouble reading street signs*
I have trouble seeing street signs*
How well do you see at night?*
Without my glasses I have trouble reading my cell phone*
Without my contacts I have trouble reading my cell phone*
Without my readers I have trouble reading my cell phone*
I have trouble reading my cell phone*
When choosing your vision correction surgeon, which matters to you?*
Would your life improve if you were less dependent on glasses and contacts?*
If you are a candidate, when would you like to have your procedure?*

Contact Info

By submitting this form, you understand that you will receive a phone call, email, and text message from Waite Vision to help you get scheduled for your Waite Vision Ocular Analysis.