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Bond Eye Associates - LASIK Savings Calculator
12
Questions
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HIPAA
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1
What is your current age?
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2
Do you currently wear...
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Glasses
Contacts
Glasses & Contacts
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3
How many years have you worn corrective lenses?
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4
How many new pairs of glasses do you purchase each year?
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5
How many new pairs of prescription sunglasses do you purchase each year?
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6
How much do you spend on new contact lenses each month?
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$75
$100
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7
How much do you spend on contact solution each month?
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8
What is the cost of your annual eye exam?
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$100
$150
$200
$250
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9
Total you will have spent on your vision by age 80:
Estimated based on your current age and the number of years you have been wearing glasses or contacts
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10
Estimated cost of your LASIK procedure:
Typical cost of LASIK procedure at Bond Eye Associates
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11
What is your name?
*
This field is required.
First Name
Last Name
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12
What is your phone number?
*
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Area Code
Phone Number
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13
What is your email address?
*
This field is required.
By including your email address, you are providing consent for Bond Eye Associates to send you marketing emails in the future.
example@example.com
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14
Total money you will save by age 80 if you have LASIK this year:
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