Information Request


Please enter the following information and either fax it to 541-757-2055
-- or --
click the "Submit Information Request" button below. Thank you.


(Information in "RED" is required in order to submit this form.)
Last Name:
First Name:
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Comments & Questions:
Please send more information about:
RK - Radial Keratotomy
AK - Astigmatic Keratotomy
PRK - Photorefractive Keratectomy
LASIK - Laser In Sity Keratomileusis
Other:

PLEASE FEEL FREE TO CONTACT US DIRECTLY FOR FURTHER INFORMATION:

Valley Eye Care
877.349.2575
541.754.6222

1505 NW Harrison Blvd.
Corvallis, OR  97330


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