703.556.9155

Dr. Andrew Holzman and Washington Nationals Ace Pitcher John Lannan

Dr. Andrew Holzman and Washington Nationals ace pitcher John Lannan

I was referred to Dr Holzman by the Washington Nationals' team eye doctor, Dr. Smithson. I definitely wanted the best surgeon who would be very careful and make sure everything was perfect. Dr Holzman at TLC came very highly recommended. I felt totally comfortable through the entire process as Dr Holzman's confidence and skill let me easily relax. It was incredibly easy. My eyesight is 20/15 now and I can't believe how much better i can see than before surgery. This was a GREAT decision for me and i am really looking forward to the up-coming baseball season with my new eyesight.

-- John Lannan
Washington Nationals

Dr. Andrew Holzman with Major League Soccer Star Alecko Eskandarian of LA Galaxy

Alecko Eskandrian Major League soccer player

Dr. Holzman, I just want to thank you and your staff for taking great care of me when I recently had LASIK surgery at your TLC office. As a pro soccer player, my vision is extremely important and directly affects my performance on the field. Just like anyone else, I had questions about LASIK surgery and made sure I did my research before choosing to go forward with it. After wearing contact lenses and glasses for most of my life, I decided LASIK was the best option and have to admit the results have been fantastic. I am able to see clearer than ever before and haven't had to worry about the frustrations of managing my contact lenses. This has helped improve my quality of life in that I no longer have had to worry about my eyesight, both on and off the field. Thank you TLC!

-- Alecko Eskandarian
LA Galaxy

Dr. Andrew Holzman is located at:

TLC Laser Eye Centers - Tysons Corner
1750 Tysons Boulevard, Suite 120
McLean, VA 22102

Ph / 703.556.9155
Fax / 703.761.4960

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Patient Questionnaire

Please fill out the form below as completely as possible. The more information you can provide to us, the better able we will be able to help you achieve better vision. Please note that fields in red are required.

Prefix
First Name
Last Name
Home Address
City
State
Zip
Email Address
Occupation
Company Name
Business Address
City
State
Zip
Date of Birth
Which of the following influenced your decision to visit Millennium?
(If you indicate more than one, please rank their order with “1” being the most influential):
Employer/Co-Worker
Web Site (Internet)
Friends/Family
Mailed Advertisement
Doctor
Radio - Favorite station
TV
Other
If a family member, friend, or employer referred you, whom may we thank?
 
Eye Care Provider:
Dr.
What treatment or procedure are you considering?
How Soon?
I currently wear:
Glasses
Reading Glasses
Soft Contact Lenses
Gas Permeable Contact Lenses
Hard Contact Lenses
Activities I enjoy:
Jogging/Running
Biking
Hiking
Going to the gym
Traveling
Tennis
Golfing
Skiing
Working out
Scuba Diving
Basketball
Swimming
Surfing
Other:
   
The reason(s) I am considering Laser Vision Correction:
 
Problems I have experienced with my contact lenses and/or glasses:
I can't see the alarm clock when I wake in the morning
I don't like putting something into my eye.
By the end of the day, my lenses are dry and irritate my eyes.
Cleaning and caring for my lenses is time consuming.
My glasses often slip down my nose and are uncomfortable.
My glasses are thick and heavy.
My glasses are sometimes painful.
I don't feel as attractive while wearing glasses.
My vision is so poor without corrective lenses that I worry about my safety when I'm not wearing them.
Medical History - Please indicate if you or any of your immediate family members have the following? (check all that apply)
Diabetes
High Blood Pressure
Cancer
Thyroid problems
Lung problems
Heart problems (pacemaker)
HIV Positive
Dry Eyes
Glaucoma
Glare bothers me
Cataracts
Pregnant or Nursing (during last 6 months)
Itching eyes
Tearing
Flashes of light
Spots / floaters
Double vision
Headaches
Please list all medications you are currently taking:
 
Are you allergic to any medications? If so, please list.
 
Do you, or does anyone you live with, smoke? Yes No
Have you ever had eye surgery? Yes No
Right Eye Left Eye
Date Date
Reason Reason
Doctor Doctor