Patient Registration Form

Patient Registration FormThe Eye Center2017-03-05T16:53:57+00:00

Patient Registration Form

Prior to your office visit, please follow the instructions below to complete the Patient Registration Form.

INSTRUCTIONS:

Download and save the Patient Registration Form PDF file.
Open the Patient Registration Form PDF file.
Print the Form.
Fill out the Patient Form completely.
Please sign the Form and bring it with you to your office visit. Thank you.

* The Patient Registration Form is Adobe Acrobat PDF format. Adobe Acrobat Reader.

When you’re chosen to be among the first in the world it says a lot about your reputation, your character, your experience.

Which is why it’s no surprise that Dr. Ayman Boutros was chosen among the first surgeons in the world to offer the breakthrough technology iDESIGN 2.0 to his LASIK patients.

This is a major advancement for patients who are over 40 and are frustrated with their reading vision.

When it comes to LASIK go with the first name that comes to mind… Dr. Boutros! Call The Eye Center at 888-844-2020 before October 31st and you’ll be upgraded to the iDESIGN 2.0 LASIK plus a $2500 savings.

Schedule your Free LASIK consultation and secure your $2500 savings!

Better Vision Through Better Care

Patient Registration Form

iDESIGN 2.0 LASIK plus a $2500 savings!