Dr. Kondrot's Program Registration

Healing the Eye and Wellness Center

40122 Mason Rd

Zephyrhills, FL 33540

800-430-9328 | info@HealingTheEye.com

Application for Dr. Kondrot's Program

All programs are held at the state-of-the-art

Florida Wellness Center in Zephyrhills, FL

Stem Cells for the eye

are now at the center!

Because of my writing, speaking and traveling schedule, the programs will be limited at the center. I will be personally conducting your treatment.

We are now also offering stem cells at the center, which is an optional part of the vision program.

One year Restore Vision Program

$14,995

Additional cost of stem cells

$9,995 (20% off if combined with Restore Vision Program)

Please fill out this form

Select Dates | Restore Vision - 2020 *

Feb 17-20Mar 17-20Apr 13-16May 11-14

Select your Program *

Healing the Eye - Restore Vision ProgramCombo w/ Stem Cells (20% off Stem Cells. SAVE $1999!)

First Name *

Middle Name

Last Name *

Street Address *

City *

State *

Postal Code *

Best Phone Number to call *

Email *

Yes! Please sign me up for your e-newsletter which contains monthly information to help maintain and improve my vision.

How did you hear about Healing the Eye and Wellness Center (Dr. Edward Kondrot)? *

If a referral, whom may we thank?

I understand that by filling out my signature (above) and clicking the "Submit" button (below) I agree to the Financial Agreement, Doctor/Patient Contract, and Treatment Consent.

You will be directed to a page to make your $997 non-refundable deposit to secure your spot.

$7,998 is required payment due at the beginning of the 3-Day Program.

You are not under any obligation to continue the program if there is not a significant improvement of your vision.