Seminar Registration Form

Seating is limited so make your reservation below

During our seminar you will be able to watch a live procedure, talk with the surgeon and the patient after the procedure, and enter a drawing for a free Vision Correction Procedure.

All fields are required

Name

Address
City
State
Zip
Daytime Phone
Email
Age

You must be present at the seminar to win the free Intralase® Bladeless LASIK procedure.