Eye-Q Vision Center

LASIK Contest

Thank you for choosing our practice for your LASIK procedure. As a token of our appreciation for your time and feedback, all video submissions will be entered into a monthly drawing for a $50 Starbucks or VISA gift card.

Please fill out the form and upload your testimonial video below

Name(Required)
Accepted file types: mp4, mov, Max. file size: 128 MB.
Video duration should be no longer than 60 seconds. Important: add your first and last name to the end of the title of your video file.
Terms and Condition Agreements(Required)
By submitting a video, I consent to EYE-Q or its agents using my likeness for advertising purposes (in-office, on the website social media, or in promotional materials) and release them from all liability. I certify that I am over 18, and this submission serves as my agreement.