Pre-Consultation Questionnaire

Thank you for booking your consultation – we look forward to speaking with you. To help us prepare for your virtual or in-office consultation appointment, please complete the form below. Your information will be kept strictly confidential.

For your convenience, the Bochner Eye Institute offers both in office and virtual consultations by appointment.

This consultation is a largely informational in nature. Your appointment will be scheduled with one of our knowledgeable refractive counselors, providing you with a one-on-one opportunity to understand the details of your potential surgery, discuss your questions, any concerns you may have, plus fees and payment plans in detail.