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California Retreatment 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, to include 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 California Retreatment 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 the optometrist are included on the form). Our medical staff will contact you within two weeks of receiving the form to discuss your next steps. If our doctors feel a retreatment may be an option for you, we will refer you to a continuity of care physician.

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