Koch Eye Laser Vision Centers

401-732-3937

We can help you determine if LASIK Laser Vision Correction is right for you.
It is our pleasure to provide you with a

Free* Evaluation.
Schedule your Free Evaluation Today!
 

Koch Eye Laser Vision Centersis dedicated to providing patients with the best possible care. In order to be certain that you get the best possible results, his approach is to provide you with individualized and personalized education and care at every step of your experience at Koch Eye Laser Vision Centers.

Koch Eye Laser Vision Centershas arranged to provide you with a FREE Evaluation Today!
 
 Please complete the following form (ALL Fields are required items*)

First Name:*

 Last Name:*

 Address:*

  City:*

 State:*

  Zip:*

Phone:*

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Please Answer The Following Questions

I wear

Glasses Contact Lenses
Bi focals / Reading glasses

I wear my glasses and/or contact lenses to see

Distance Near Both Distance and Near

I am interested in having Laser Vision Correction within
the next month 6 months
3 months 12 months

Please Indicate Your Acceptance.

Please contact me to schedule a

Complimentary Evaluation
A Treatment Date
Please contact me regarding
Corporate Benefit Programs
An affordable payment plan
Please include me in further informational mailings

 Please select the best time to be reached by our Refractive Surgery Coordinator:

 
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*(see important note)