topnavstaff

 
 

We know you have many questions. We're looking forward to answering them.

Complete the following form and receive a
FREE downloadable Copy of
our book

Note: Fill in required items(*) in order to receive your
FREE copy of LASIK Vision Correction

First Name:*

  

 Middle Initial:

  

 Last Name:*

  

 Address:*

  

  City:*

  

 State:*

  

 Zip:*

  

 Day Phone:

  

 Evening Phone:

  

 E-mail:*

  

Please send me more information regarding
Laser Vision Correction:  
 yesno
Please contact me regarding scheduling a
Complimentary Evaluation:
 yesno
Please contact me to be preapproved for
an affordable payment plan:  
 yesno
Please contact me regarding scheduling a treatment date:
 yes no
Please include me in further informational mailings:  
 yesno
Please allow me on-line access to your book
LASIK Vision Correction - Doctor to Patient Series:
yesno


 How did you hear about us?*
If other, please comment:

 Reset Form:
 Submit Form:

Toll Free: 800.423.3937

1100 Gulf Freeway, Suite 114, League City, Texas 77573 - phone: 281.332.3937
2302 Avenue P, Galveston, Texas 77550 - phone: 409.765.6324
6409 Memorial Drive, Texas City, Texas 77691 - phone: 409.938.8437


LASIK Laser Eye Surgery | visit our practice | meet our staff | Custom Wavefront LASIK
other patient services | home | site map | legal disclaimer
©2000/2001/2002/2003 The Medical Management Services Group, L.L.C.
Last updated6/03