Am I Suitable


Our surgeons at Odisha Lasik Centre want to help you determine whether or not you are a candidate for Laser Vision Correction. In order to better understand if you would be a good candidate please take a moment to complete the form below. Once your visual needs and lifestyle requirements have been determined our patient coordinators will be have a better idea of your suitability as well as what vision correction procedure(s) might be applicable.

Please fill the mandatory filed, So that we will get back to you as quick as possilble.

* Name
* Phone
* Email
What is your occupation ?
How did you here about us ?
What is the best time to contact you ?
Q1. Do you have trouble seeing far away or up close without an optical aid? (tick more than one if needed)
Q2. What optical aid do you use for correcting your vision currently ?
Q3. What is ur age ?
Q4. Are you interested in seeing well up close (reading) without glasses?
Q5. Do you know your approximate visual prescription ?
Q6. Do you have astigmatism ?
Q7. Has your prescription been stable over the last two years ?
Q8. Do your eyes hurt after prolonged eyewear use ?
Q9. Are you prepared to undergo a 2 to 3 hour preoperative evaluation ?