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Re-treatment Evaluation Form

Thank you for choosing LasikPlus Vision Centers. If you feel that you may need a retreatment due to a change in your vision, the first step is to have a comprehensive dilated eye examination that includes a cycloplegic refraction.

  • Please see a regular eye doctor with whom you would prefer to have this exam, and please let him or her know you are in need of a comprehensive, dilated exam including cycloplegic refraction.
  • Please print this Laser Vision Re-treatment Evaluation form and have your eye doctor complete it during your exam.

Once your eye doctor has completed the needed eye exam, he or she should send the completed Retreatment Evaluation form, along with your records for us to review (instructions for your eye doctor are included on the form). Our medical staff will contact you within two weeks of receiving the form and records to discuss your next steps. If our doctors feel a re-treatment is the best option for you, we will bring you in for additional laser eye surgery testing. The fee for this exam is $75*.

We hope this information is helpful to you! If you or your eye doctor have any questions, please give us a call.

*Fee is subject to change and may vary in Ft. Lauderdale, FL; Northville and Warren, MI; and Oklahoma City, OK.