Please enable JavaScript in your browser to complete this form. – Step 1 of 4 What Is Your Age Group? * Under 18 19 – 39 40 – 49 50+ Without My Glasses Or Contacts… * I have trouble reading and seeing things up close. I have trouble driving and seeing things far away. check all that apply What Do You Usually Wear? * Progressives/Bifocals Distance Glasses Reading Glasses Contacts None check all that apply Next Do You Have Any Of The Following? * Astigmatism Rheumatoid Arthritis Lupus Keratoconus Previous Eye Surgery Currently Pregnant Multiple Sclerosis Cataracts Diabetic Retinopathy Prior Major Eye Injury Prosthetic/Fake Eye None Of The Above How important is it for you to enjoy outdoor activities and/or sports without glasses and contacts? * It’s very important to me NOT to wear any glasses. I do not mind wearing glasses for distance. I do not mind wearing glasses for reading. Would your career or business activities improve if you were to become less dependent on glasses and contacts? * Yes No Maybe Next How Much You Could Save With LASIK A 2019 study performed by the Canadian Association of Optometrists showed that, on average, Canadians spend $350/year on their prescription lenses. By getting laser vision correction now, someone in their mid 30’s could save approximately $7,000 while someone in their mid 20’s could save over $10,500 throughout their life! Don’t wait, start saving now by getting laser vision correction with BCLasik! Do You Want To Save Money By Getting Laser Vision Correction? Yes, I want to save money! No, I like paying for my prescription lenses. Next Looks Like You Could Be A Great Candidate For LASIK Or One Of Our Other Refractive Procedures! Name * First Last Email * Phone Number * Preferred Clinic Location *please select a locationSurreyAbbotsford Would you like to learn about your vision correction options with one of our Vision Counselors? * Yes No Submit