Practitioner Feedback Survey

Practitioner Feedback Survey
THANK YOU for selecting NaturalVue® (etafilcon A) Brand Contact Lenses. We hope that you are enjoying them.

We value your opinion so that we can assess the quality of our products and work to continuously improve them. The survey should take you less than 5 minutes to complete.

You agree that Visioneering Technologies, Inc. (“VTI”) will own all right, title and interest to your responses to the survey, and that VTI may freely use your survey responses for any purpose, provided that VTI hereby agrees not to publicly disclose your individual survey responses except in an aggregated format with other survey responses in which responses are not identifiable to an individual respondent.*

I agreeI do not agree
Please select the country in which you practice.*
Type of NaturalVue® Contact Lenses that you prescribe:*

NaturalVue® MultifocalNaturalVue® Enhanced MultifocalNaturalVue® SphereBoth NaturalVue Multifocal and Sphere

For what indication do you primarily prescribe for NaturalVue® Multifocal?

Primarily PresbyopiaPrimarily for the Management of Myopia (see below for Indications for Use)BothOther

	Number of Multifocal Patients
Ages 0-6
Ages 7-15
Ages 16-29
Ages 30-39
Ages 40-45
Ages 46-50
Ages 51-55
Ages 56-60
Ages 61-65
Ages 65+

Please rate your overall satisfaction with NaturalVue® 1 Day Contact Lenses:*

Have any of your patients ever voiced any of these common contact lens complaints after wearing NaturalVue? If so, please check which problems you have heard mentioned (check all that apply):*

HalosGhostingBurning and itchinessStingingGrittinessRed eyesEye drynessDifficult to insertDifficult to removeLight sensitivityInconsistent vision from lens to lensNeovascularizationLenses tear easilyNo problems experiencedOther
Have you had any patients experience any adverse events (such as corneal ulcers, corneal abrasions, corneal edema, eye infections, or more serious side effects from the use of NaturalVue® products?*

YesNo
Please describe specific details:*
How can we improve our product to better meet your patients' needs?

Click here for Indications for Use
NaturalVue® (etafilcon A) Multifocal 1 Day Contact Lens 510(k) US Indication for Use:
NaturalVue (etafilcon A) Multifocal Daily Disposable Soft (Hydrophilic) Contact Lenses are indicated for daily wear for the correction of refractive ametropia (myopia and hyperopia) and/or presbyopia in aphakic and/or non-aphakic persons with non-diseased eyes in powers from -20.00 to +20.00 diopters and with non-diseased eyes who may require a reading addition of up to +3.00D. The lenses may be worn by persons who exhibit astigmatism of 2.00 diopters or less that does not interfere with visual acuity.

NaturalVue® (etafilcon A) Multifocal 1 Day Contact Lens Indication for Use Outside the US:
NaturalVue® (etafilcon A) Multifocal Daily Disposable Soft (Hydrophilic) Contact Lenses are indicated for daily wear for the correction of refractive ametropia (myopia and hyperopia) and/or presbyopia, and myopia progression control in aphakic and/or non-aphakic persons with non-diseased eyes in powers from -20.00 to +20.00 diopters and with non-diseased eyes who may require a reading addition of up to +3.00D. The lenses may be worn by persons who exhibit astigmatism of 2.00 diopters or less that does not interfere with visual acuity.
How likely are you to recommend NaturalVue® 1 Day Contact Lenses to patients?*

1

2

3

4

5

1 is No Way, 5 is 100% Will
MKT-OUS-NVU-13 r1

Practitioner Information