Vision Correction

Gift of LASIK with the IntraLase Method™*

Let family and friends know that you want LASIK for a holiday, birthday, anniversary
- or just because!

Your name:
Your e-mail address:
Your gender:	Female Male
I would like
	to send me the Gift of LASIK with the IntraLase Method™*
Gift giver's e-mail address†
Would you like to receive news and updates from Austin Eye Clinic? Yes No

*The IntraLase Method can only be performed using the IntraLase® FS laser.

†This e-mail address will not be used for purposes other than to alert the recipient of the Gift of LASIK with the IntraLase Method ™. The e-mail address will not be shared, sold, or exchanged with any other third party company.

©2006 IntraLase Corp. All Rights Reserved. IntraLase is a registered trademark of IntraLase Corp. and the IntraLase Method is a trademark of IntraLase Corp. Mkt Doc 592 Rev. A