EVO ICL Candidacy Test | Boston & Quincy, MA

First Name(Required)

Last Name(Required)

Email(Required)

Phone(Required)

What is your age group?(Required)

Without my glass and contacts(Required)

What do you usually wear?(Required)

List any of the following you have:(Required)

Rheumatoid Arthritis, Lupus, Keratoconus, Prior Eye Surgery, Currently Pregnant, Multiple Sclerosis, Cataracts, Diabetic Retinopathy, Prior Services Eye Injury, None of the above

How interested are you in being able to enjoy outdoor activities and / or sports without glasses and contacts?(Required)

Are you interested in seeing well up close(reading) without glasses?(Required)

Would your career or business activities improve if you were to become less dependent on glasses and contacts?(Required)

Would you be willing to discuss this procedure and your candidacy with our coordinator?(Required)

Message(Required)

Phone

617.471.5665

Toll Free

877.373.2020

Fax

617.665.6703

Hours

Mon: 7:00AM – 3:30PM
Tues: 8:30AM – 5:00PM
Wed: 8:30AM – 5:00PM
Th: 8:30AM – 5:00PM
Fri: 7:00AM – 3:30PM
*Sat: 8:00AM – 12:00PM
*(Quincy Office Only)

EVO ICL Candidacy Testin Boston, MA

Phone

Toll Free

Fax

Hours