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Complete the fields that apply to the products and services you need.
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Name
*
Email
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Services
Practice Consulting
Acquisition
Selling
Service Agreements
HIPAA Compliance
Credentialling/Compliance
Billing/Coding
Product(s)
Full Lane
Chair
Stand
Slit Lamp
Chart Panel
OCT
Topography
Camera (retina)
Vision Screening
VFA
Diagnostics
Laser
Phaco
Surgical Microsope
Surgical Instruments
Surgical Packs
Virectomy
Condition
New
Used
Warranty
Yes
No
Certified by Manufacturer
Yes
No
Budget Expectation
$0-$8000
$8001-12000
$12001-$20000
Will you need financing?
Yes
No
Addtional Information(optional)
*
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Contact
Direct: 727-317-8063
Support: 1-855-410-7999
Email: info@eyedirect.com
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