Our Patient Educaton Videos Can Only Be Found Here

Complete This Form To View Our Video Library!

You will receive a Personal Recommendation from Dr. Chynn himself about which procedure is right for you given your age, occupation, and special concerns.

Name:

Enter your first name here

*
e-mail:

You Must provide a valid email, Dr. Chynn will send you the gallery link to the address given

*
Phone #: *
Age:

So we can recommend the correct procedure for your age.

*
Occupation:

To tailor your procedure to your visual needs!

(not required)
Insurance:

Your medical (not vision) insurance, so we can offer you an insurance discount!.

(not required)
Company:

So we can offer you a corporate discount!

(not required)

I have my eyeglass or contact lens prescription handy.

left Eye:

Give an approximation: (glasses/contacts, include the +/- sign, i.e., -3.50)

(not required)
Right Eye:

Give an approximation: (glasses/contacts, include the +/- sign, i.e., -3.50)

(not required)