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Dry Eye Quiz

DRY EYE QUESTIONNAIRE

Dry Eye Disease is the most frequent reason that patients visit eye doctors. We are concerned that you may be suffering with this condition as well. Therefore, we would ask that you take a few moments and thoughtfully complete the questionnaire below.

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Report the Frequency and Severity of your symptoms using the rating list below:

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  • * All indicated fields must be completed.
    Please include non-medical questions and correspondence only.
  • This field is for validation purposes and should be left unchanged.