Discount Plan Application
PRODUCTS INCLUDED: VISION AND LASIK
Espanol
Step 1: Billing Options

Select a billing option:
 
Member Only
/Month
/Year
(A 10% Savings)
Member Plus Family
/Month
/Year
(A 10% Savings)

*Plus a one-time non-refundable processing fee of $10.00


 
$5.95 billed monthly + $10.00 one time non-refundable processing fee


Total = $15.95 will be charged for your first month, $5.95 will be charged monthly thereafter



When would you like your membership plan to start?


FORM CODE CICONLINEAPP


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