Welcome Questionnaire.

It would help us if you can complete this Questionnaire once before your appointment.

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* 1. Please type in your name and email address for your file.

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* 2. Are there any eye conditions in your immediate family

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* 3. If new to the practice when was the last time you had your eyes examined?

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* 4. Do you currently wear eye wear for different tasks? You can select more than one option. Please bring them along to the examination. ( * = available as a 2nd pair from $299)

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* 5. Do you have any recent health issues?

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* 6. Where do you work or study? Also how far away in cm are your digital devices from your eyes?

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* 7. What sports, interests or hobbies do you enjoy?

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* 8. If you wear glasses do you have sun protection?

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* 9. Are you interested in Contact Lenses? They are now available for children and for people wearing progressives.

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* 10. What helped you decide to make this appointment?

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