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Is Orthokeratology Right For Me?
Take this quick quiz to find out.
12
Questions
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English (US)
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1
Full Name:
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First Name
Last Name
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2
Email
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example@example.com
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3
Phone Number
Area Code
Phone Number
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4
How old are you?
Under 21
21-45
46-59
60+
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5
What kind of corrective lenses are you currently using?
Contacts
Glasses
Both
Neither
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6
Why do you wear corrective lenses?
I have trouble seeing far (nearsighted)
I have trouble seeing close (farsighted)
I have trouble seeing far and close
I don't have trouble with my vision
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7
Where are you in your search for looking for a vision correction procedure?
I've just started my search
I'm ready to set up an appointment for a consultation
I've made an appointment for a consultation
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8
What bothers you about wearing contacts? (check all that apply)
I don't wear contacts
Dry eyes
not being able to see or participate in certain activities (e.g. swimming)
The daily routine of taking contacts in and out
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9
What bothers you about wearing glasses? (check all that apply)
I don't wear glasses
Fogging
Not being able to see/participate in certain activities (e.g. swimming)
Not being able to wear glasses without prescription
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10
Which of the following would be important to you in a vision correction procedure? (check all that apply)
Doesn't cause dry eyes
Is reversible
Is safe and gentle
Convenience
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11
How important is the price of the vision correction procedure you'll get?
Price is not a concern of mine
I'm on a budget
I'm willing to invest in the right procedure
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12
I'd like to be contacted about the best vision options for me with exclusive discounts & promos.
*
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Please check yes to agree or uncheck to opt-out.
Yes
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13
Results
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