Join the SynergEyes Research Study Participant Pool

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1. Are you at least 18 years of age?

Yes

No

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2. First Name:

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3. Last Name

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4. Preferred Name

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5. Email Address

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6. Phone Number

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7. Zip Code

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8. Do you currently wear prescription contact lenses?

Yes

No

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9. Have you ever been diagnosed with an irregular cornea?

Yes

No

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10. Are you able to travel to our Carlsbad, CA location, and would you be able to travel regularly for a period of up to 6 months?

Yes

No