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1. What is your age group?
under 18
19-39
40-59
60+
Please select your Age
2. Without my glasses and contacts: (check all that apply)
I have trouble reading and seeing things up close
I have trouble driving and seeing things that are far away
I've been told that I have astigmatism
Please describe your vision.
3. What do you usually wear? (Check All that Apply)
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Please select what you wear.
4. Do you have any of the following?
Rheumatoid Arthritis
Multiple Sclerosis
Lupus
Cataracts
Keratoconus
Diabetic Retinopathy
Prior Eye Surgery
Prior serious eye injury
I am currently pregnant
None of the above
Required
5. Yes, I would like to schedule a FREE Consultation. The best time to call me is:
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4pm-7pm
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6. Please provide us with your contact information:
First Name:
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Email Address:
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7. Would you like to receive a Free LASIK Info Kit?
Yes, Please mail my kit to the following address
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Zip Code:
Required.
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Dr. Paul L. Wright, M.D.
Read Bio
Cris Mathews, P.A.-C
Read Bio
Dr. Terry J. Wolthuis, O.D.
Read Bio
240 Minnesota Street Rapid City, SD 57701
Phone: 877-576-0202
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