Eye Surgery New York
Loyalty Program

Request FREE Screening, Appointment-Chelsea Eye

Welcome to our Patient Loyalty Program. Our goal is to make each of your visits a rewarding experience. This program is our way to thank you for your confidence in us, and we hope you will share your experience with your family and friends.

Step 1:
Enroll in the program by filling out and submitting the form below.

Step 2:
Earn points for cosmetic procedures, surgery, and vision correction procedures that are elective or by referring a friend who has an elective procedure.

You earn:

  • 1 point for each skincare treatment package or filler/toxin treatment

  • 2 points for referring a friend
    (Your friend must bring the referral card with your name on it. Receive referral cards at our front desk or click here to download.)

  • 5 points for each surgery including laser vision correction, premium intra-ocular implants (IOLs), cosmetic surgery and Smart Lipo.

Step 3:
Profit from Your Points!

10 points = SILVER status. You receive 10% off qualifying elective procedures/treatments and your Patient Loyalty Card.

Continue to earn points to realize even more cost savings.

20 points = GOLD status (receive 15% off all future procedures/treatments)
30 points = PLATINUM status (receive 20% off all future procedures/treatments)

Your points are active for three years from your enrollment date. After you reach PLATINUM status, any extra points you earn will roll over into the next enrollment period.
Points can also be transferred to friends and family members!

Online VIP Enrollment Form

* REQUIRED FIELDS FOR ENROLLMENT
First Name *
Last Name *
Address
City
State
Zip Code *
Phone
Email *

Please check all that apply:
I am an established patient at Chelsea Eye/Cosmetic
I have had cosmetic treatments at Chelsea Eye/Cosmetic
I have had LASIK/IOL or Cosmetic Surgery at Chelsea Eye/Cosmetic
I have had skincare services at Chelsea Eye/Cosmetic
I use a custom skincare program from Chelsea Eye/Cosmetic

Please send me emails on specials events or other offers that may be of interest.*

Yes No

I am interested in more information about...(please list in the box to the right)
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