LASIK Self-Test Take our LASIK self-test and a NYLASIK staff member will contact you to answer any questions and schedule you for a Free LASIK consultation! Name* First Last Phone*Email* Age Group*18-2526-3940-4950-5960+Do You Currently Wear for Vision Correction?*GlassesContactsGlasses & ContactsReading GlassesBifocals or TrifocalsHave You Had Any Previous Eye Diseases or Eye Surgeries?*YesNoHow Did You Hear About Us?*Internet/GooglePatient ReferralDoctor ReferralYelpOtherCAPTCHAEmailThis field is for validation purposes and should be left unchanged.