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- Marlton – Formerly Sandler Eye Care

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- Marlton – Formerly Sandler Eye Care

Home » Eye Care Services » Dry Eye » Dry Eye Questionnaire

Dry Eye Questionnaire

Name: Marlton Location (Formerly Sandler Eye Care)
Address: 701 Route 73 N, Suite 3, Marlton, NJ, 08053, US
Telephone: (856) 988-1118
Price range: $000 - $300

Please answer the following questions by checking the box that best represents your answer. Select only one answer per question.

1. Do you experience EYE DISCOMFORT?

a. During a typical day in the past month, how often did your eyes feel discomfort?(Required)

Never

Rarely

Sometimes

Frequently

Constantly

b. When your eyes felt discomfort, how intense was this feeling of discomfort at the end of the day, within two hours of going to bed?(Required)

None

Mild

Moderate

Severe

Very Severe

2. Do you experience EYE DRYNESS?

a. During a typical day in the past month, how often did your eyes feel dry?(Required)

Never

Rarely

Sometimes

Frequently

Constantly

b. When your eyes felt dry, how intense was this feeling of dryness at the end of the day, within two hours of going to bed?(Required)

None

Mild

Moderate

Severe

Very Severe

3. Do you have WATERY EYES?

During a typical day in the past month, how often did your eyes look or feel excessively watery?(Required)

Never

Rarely

Sometimes

Frequently

Constantly

Score

Would you like for us to review your score with you?(Required)

Yes

No

Please enter your contact information below, and one of our team members will reach out to you to discuss your dry eye score.

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Marlton Location (Formerly Sandler Eye Care)

701 Route 73 N, Suite 3
Marlton, NJ 08053

Phone: (856) 988-1118

Monday:11:00 AM - 7:00 PM
Tuesday:9:00 AM - 5:00 PM
Wednesday:10:00 AM - 5:00 PM
Thursday:12:00 PM - 8:00 PM
Friday:9:00 AM - 5:00 PM
Saturday:Closed
Sunday:Closed

Collingswood Location

571 Haddon Ave
Collingswood, NJ 08108

Phone: 856-858-3937
Email: info@premiereyedoctors.com
(Do not send personal health information by email.)

Monday:10:00 AM - 5:00 PM
Tuesday:9:00 AM - 5:00 PM
Wednesday:10:00 AM - 6:00 PM
Thursday:9:00 AM - 7:00 PM
Friday:9:00 AM - 5:00 PM
Saturday:Closed
Sunday:Closed

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Your Rights and Protections Against Surprise Medical Bills

Home
Contact Us
What’s New
Disclaimer
HIPAA Official Notice of Privacy Practices
Your Rights and Protections Against Surprise Medical Bills

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Collingswood Location
571 Haddon Ave
Collingswood, NJ 08108
Phone: 856-858-3937
https://www.premiereyedoctors.com

Marlton Location (Formerly Sandler Eye Care)
701 Route 73 N, Suite 3
Marlton, NJ 08053
Phone: (856) 988-1118
https://www.premiereyedoctors.com

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