Request Information If you are interested in learning more about Laser Vision Correction please complete this form and click on "send information" below. We look forward to speaking with you. Name (first): Name (last): Home Address: Tel - Work: Tel - Home: Tel - Cell: Fax: E-Mail: Would you like us to send you further information regarding Laser Vision Correction? YES NO Would you like our Laser Vision Coordinator to contact you to arrange for a consultation in our office? YES NO Would you like to receive information regarding payment options? YES NO Is there any other way in which we may assist you? Special travel arrangements can be made for people outside of the New York area. Should you have a specific question or need, just call us. We're here to assist you!