| Questionnaire |
1. |
What age range
do you fall into? |
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2. |
When do you wear spectacles? |
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3. |
Which of these do you do regularly? |
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4. |
Do you suffer from any long term medical conditions? |
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5. |
Have you ever had your hearing checked? |
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6. |
If you wear spectacles what type do you wear? |
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7. |
Do you wear contact lenses? |
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8. |
If NO, have you ever thought of wearing contact lenses? |
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9. |
If you wear contact lenses what type do you wear? |
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10. |
How did you hear about us? |
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11. |
When was your last eye examination? |
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Are there any further comments you would like to add that would help improve our service? |
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