Welcome to Look Better, See Better, Feel Better

How to enroll?

You can download our Printable Enrollment form here

Or you can enroll online by completing the form below:

Individuals are $12.00 per year.

Families are $24.00 per year

Personal Info Information (Fields with * are required)

Title:

First Name:

* Last Name: * MI:

Address:

Address 2:

City: *

State:

* Zip Code: *

Gender:

* SS No.:

Date of Birth:

Telephone:

Email:

Referral Source

If you have a Referral Source please fill in the applicable fields below, type "NONE" if you don't have:

Name:

Company:

Address:

Telephone:

Website:

E-mail:

Membership Information

Type:

Newsletter:

Yes No

I hereby apply for enrollment in the Vision Advantage plan called Look Better, See Better, Feel Better and understand that my Enrollment Fee is good for one year. I understand that I can re-enroll each year which will extend the expiration date on my LookBetterSeeBetterFeelBetter membership card for one year.

Agree Disagree