Schedule Now! Schedule Your FREE Consultation!Please fill out all information. This information will only be used to provide you a custom consultationspecifically suited for your vision, as well as to contact you.Personal Information Select Your State *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming (Birth Month and Year used only to verify age). You must be at least 18 years old to schedule a screening Birth MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Birth Year20001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900 Select Location for Consultation *DenverFort CollinsBroomfield/Boulder Valley Vision InformationAre You? NearsightedNearsighted w/AstigmatismFarsightedFarsighted w/AstigmatismWear Reading GlassesI Don't Know What Procedure Are you Interested In? LASIK / PRKNearVisionICL / Lens ImplantKeratoconus / CXL / IntactsCataract / Lens ImplantPterygium / CarnosidadCornea Transplant How did you hear about us? EventDirect MailReferral of a FriendPhysician ReferralInternetRadioFacebook/Twitter Do you need to finance your surgery? Yes NoWho's your Optometrist? You can schedule your consultation appointment online, at a time that is convenient for you. If you would like to schedule your appointment now: If you would rather have us contact you to schedule your appointment or you have additional questions for our Refractive Counselors, please: