Home | Return to Previous Page



Contact Us

Contact Us for More Information

Fill in the appropriate fields:

Name: (Required--please include your middle initial.)
Address:
City:
State:
Zip:
Daytime Phone:
Evening Phone:
Email: (Required)
Age: Male Female
Date of Birth:
Are you interested in
(check all that apply):
Attending a free seminar
LASIK with the IntraLase MethodTM
Scheduling a complimentary consultation
Receiving a Senior Eye Health brochure
Having information mailed to your home address
Applying for financing
Other
Please understand that you are submitting this request over the Internet. Do not include any sensitive medical information in your appointment request, for we cannot guarantee that it will not be seen by other parties.
   
How can we help you?

VISIT US AT: 7950 College Blvd.,Suite B
Overland Park, Kansas 66210

PH: 913-338-4733 | 800.752.3937 | FAX: 913-906-6551