selftest-tri-cities-townsquare.myk2vision.com Open in urlscan Pro
2606:4700::6811:deda Public Scan

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Submitted URL:
https://selftest-tri-cities-townsquare.myk2vision.com/
Effective URL:
https://selftest-tri-cities-townsquare.myk2vision.com/?cookieUUID=3436a6c5-ff97-4137-aa23-0250b3b2fe91&affiliate=0
Submission: On October 13 via automatic, source certstream-suspicious (October 13th 2024, 2:42:34 am UTC) — Scanned from DE

Form analysis
10 forms found in the DOM

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Text Content

WELCOME TO YOUR 
VISION SELF TEST

TO START

PLEASE TELL US HOW OLD YOU ARE

Under 18
19-39
40-55
56+


  Call to action


QUESTION 2:

HAVE YOU EVER BEEN TOLD YOU HAVE ASTIGMATISM?

Yes
No


  Call to action

QUESTION 3:

DO YOU HAVE TO WEAR GLASSES/CONTACTS FOR?

Driving
Computer
Reading
All of the above


  Call to action

QUESTION 4:

HAVE YOU HAD ANY OF THE FOLLOWING PROCEDURES ON YOUR EYES (LASIK, PRK, RK,
CATARACT SURGERY)?

Yes
No


  Call to action

QUESTION 5:

DO YOU SUFFER FROM MULTIPLE SCLEROSIS, LUPUS, KERATOCONUS OR DIABETIC
RETINOPATHY?

Yes
No


  Call to action

QUESTION 6:

IF YOU WERE TO COME IN FOR A CONSULTATION, WHICH LOCATION WOULD WORK BEST FOR
YOU?

Please Choose A Location Please Choose A Location
KennewickVancouverLynnwoodTacomaTigardTukwilaScottsdale

  Call to action

QUESTION 7:

WHAT EMAIL SHOULD WE SEND THE RESULTS TO?

  Next

QUESTION 8:

WHAT IS YOUR FIRST NAME?

  Next

QUESTION 9:

WHAT IS YOUR LAST NAME?

Last Name


  Next

QUESTION 10 (THE FINAL ONE!):

WHAT PHONE NUMBER CAN WE USE TO CALL/TEXT YOU?

Phone


  Submit
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Question 1 of 10


Unfortunately you are not a candidate for RLE or ICL due to your age (18 or
under). If you entered this age by mistake, refresh the page and select your age
again.

Unfortunately you are not a candidate for RLE or ICL due to having one of the
pre-existing medical conditions that were listed. If you entered that you have
one of those pre-existing conditions by mistake, refresh the page and select
your choice again.

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Text Content

selftest-tri-cities-townsquare.myk2vision.com Open in urlscan Pro
2606:4700::6811:deda Public Scan

Form analysis
10 forms found in the DOM