LASIK Self Evaluation Online Form

Lasik self evaluation, Mitchell A Jackson, MDThe fastest way to check LASIK qualification is to do an online Lasik self evaluation yourself. You can use form below to submit information about your case to our office and we will get back to you with initial information about procedures allowed for you.

What is your age group?

What do you usually wear? (Check All that Apply)

Do you have any of the following?

Yes, I would like to schedule a FREE consultation.
The best time to call me with results is:

While it’s a good starting point to see whether you qualify for LASIK, with a self evaluation form, we’d suggest to schedule a free appointment in one of our offices in Lake Villa or Lindenhurst,  near Chicago, Illinois. Our team will provide a free consultation to determine further steps for the best visual outcome in your individual case. Schedule appointment online at Contact Us page or by phone 847-356-0700. Our office location is especially convenient for the citizens of Chicago, Kenosha, Waukegan, Barrington, McHenry, Gurnee, Lake Zurich, Antioch, Graylake and other places to the North and Northwest of Chicago.