LASIK and PRK
Corneal Cross Linking
Clear Lens Exchange
Advanced Dry Eye
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Dr. Alan Barber
Dr. Michael Bollenbacher
Dr. Teresa Carlson
Dr. Thomas Cruse
Dr. Isha Gupta
Dr. C. Starck Johnson
Dr. Crystal Kasper
Dr. Ketty Lee
Dr. Chandni Merchant
Dr. Robert E. Prouty
Dr. Sumit A Sitole
Dr. Richard Stewart
Dr. Carl Tubbs
InSight Vision Group Parker
InSight LASIK Parker
InSight Vision Group Denver
InSight Vision Group Boulder
InSight LASIK Boulder
InSight Vision Group Longmont
InSight Vision Group Fort Collins
Thank you so much for your patient referral!
Unless marked Urgent, we will contact your patient in the next 24 to 48 hours, Monday thru Friday, to schedule an appointment. We will contact you, via your indicated communication preference, if we are unable to reach your patient after three attempts. To save and/or print the referral you sent, please click
to return to your portal. In the View Past Referrals dropdown menu, select the patient you would like to save or print the referral on.
Schedule an Appointment
Are you a current patient?
InSight Fort Collins
I currently wear (check as many that apply)
Gas Permeable Contacts
Please describe the nature of your appointment (e.g., consultation, check-up, etc)
LASIK Candidacy Survey
Please complete the following questions to help us provide you with an appropriate response.
Who is your current eye doctor?
Which location would you prefer?
LASIK Parker Office
LASIK Boulder Office
What Age Group Are You In?
Under 18 Years Old
19-39 Years Old
40-59 Years Old
I wear glasses and contacts because (check all that apply)
I have trouble reading and seeing things up close
I have trouble driving and seeing things far away
I have astigmatism
What do you usually wear (check all that apply)
I don't wear correction and probably should
Have you ever had (check all that apply)
Previous Eye Surgery
A serious eye injury
Where do you live your visual life (check all that apply)
I love the outdoors and am active
I love reading
I love participating in sports
I spend hours on my computer
What are your expectations after LASIK? (check all that apply)
I am fine wearing glasses for distance
I do not want to wear glasses for distance
I am fine wearing glasses for up close and reading
I do not want to wear glasses for seeing up close
Would you be willing to review your level of candidacy with one of our InSight LASIK Counselors?