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Phone:
(305) 825-2020
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Optical:
(305) 822-0099
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Our Team
Joseph Trentacoste MD
William Zambrano MD
Adalberto B. Acuña OD
William Zambrano Jr, MBA, OD
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Am I eligible for LASEK?
Full Name *
Email Address *
Phone *
Has your vision changed significantly within the last year?
Yes
No
Do you wear contact lenses or glasses most of the time?
Contacts
Glasses
Neither
Without glasses and contacts, do you have trouble seeing far away or up close?
Far Away
Up Close
Both
Is it a goal of yours to be able to play activities such as sports without glasses and contacts?
Please select
It’s very important to me NOT to wear glasses for activities such as sports
It’s not important to me. I do not mind wearing glasses
None of the Above
Would you improve the quality of your life by being less dependent on glasses and contacts?
Yes
No
Maybe
Have you ever been told that you are not a candidate?
Yes
No
How old are you?
18 - 21
22 - 44
45 - 64
65 +
How Did You Hear About Us? *
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