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:: SITE LAST UPDATED: 3.10.2010  

Contact Us for More Information

We are here to answer your questions and ease your concerns. Feel free to complete the form below. Thanks for your interest, and we look forward to improving your vision.

 This form just takes a moment to use.
Name: (Required)
Address:
City:
State:
Zip:
Daytime Phone:
Evening Phone:
Email: (Required)
Age: Male Female
   
Are you interested in
(check all that apply):
Attending a free seminar for LASIK
Scheduling a complimentary consultation for LASIK
Having information mailed to your home address
Applying for financing
Other
   

What should we know about you?

This is not a secure contact form. Please do not include sensitive medical information in your appointment request that you would not normally feel comfortable sending over email.

:               

 

 
Events
·  Read about our events!
Appointments
· Schedule a consultation with our doctors. Tell us when you would like to visit.
 

VISIT US AT: 3000 W ML King Blvd Tampa, Fl 33607
PH: (813) 877-2020 | 1-800-633-3549 (Florida only) | FAX: (813) 872-7387
EMAIL: jbrtec@aol.com

Why Choose Us? | Doctors | Patient Forms | Events | News | Vision Correction | Cosmetic | Technology | Eye Health
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