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Lasik Doctors
 
Refractive Surgeon
Complaint

USAEyes is interested in information regarding any negative refractive surgery experience - even if the doctor is not associated with our organization.

By filing a complaint, you will be providing us with important information that will be considered in the evaluation process of any refractive surgeon seeking certification by our organization.

Submitting information to USAEyes is not a substitute for submitting an official complaint to a governmental regulatory agency or seeking restitution though litigation.

We do not guarantee that we will respond directly to your problem, however you may be contacted regarding your complaint.

The information in color is required to submit a complaint.

Thank You

  1. Please provide the following information about yourself:
    First Name
    Last Name
    Middle initial
    Title
    Organization
    Street Address
    Address (cont.)
    City
    State
    Zip Code
    Work Phone
    Home Phone
    FAX
    Email
  2. Please describe yourself:
    Date of Birth mm/dd/yy
    Sex Male Female
  3. Enter date the procedure was performed :

    -- mm/dd/yy

  4. Please provide the following information about the refractive surgeon:
    First Name
    Last Name
    Middle initial
    Organization
    Street Address
    Address (cont.)
    City
    State
    Zip Code
    Work Phone
    E-mail
  5. Describe the complaint. Include as much detail as necessary:


Last updated Saturday, April 08, 2006

"Consider and Choose With Confidence" TM
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Materials presented in this website are for informational purposes only and are not medical advice. See full Terms of Use.
Unless otherwise indicated, Copyright 1997-2008 © Council for Refractive Surgery Quality Assurance, a nonprofit organization.
8543 Everglade Drive, Sacramento CA 95826-3616, USA, 800/USA-Eyes
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USAEyes, CRSQA, ComplicatedEyes, Council for Refractive Surgery Quality Assurance,
50 Tough Questions For Your Lasik Doctor, and Consider and Choose With Confidence are trademarks of the
Council for Refractive Surgery Quality Assurance
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