Contact Lens Recommendation Quiz
Answer a few questions to find the best contact lenses for your needs.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
What is your primary vision correction need?
*
Nearsightedness (Myopia)
Farsightedness (Hyperopia)
Astigmatism
Presbyopia (age-related reading difficulty)
Not sure
Have you worn contact lenses before?
*
Yes, currently wear them
Yes, but not currently
No, never worn contact lenses
How often would you like to replace your contact lenses?
*
Daily (single-use)
Bi-weekly
Monthly
Not sure
How many hours per day do you plan to wear your contact lenses?
*
Please Select
Less than 4 hours
4-8 hours
8-12 hours
More than 12 hours
Which of the following best describes your daily activities? (Select all that apply)
*
Work at a computer/screen for long periods
Play sports or exercise regularly
Spend time outdoors
Travel frequently
Sensitive or dry eyes
Other
Do you have any known eye health conditions?
*
Dry eyes
Allergies
Eye infections (past or present)
None
Other
How important are the following factors to you when choosing contact lenses?
*
Rows
Very Important
Somewhat Important
Not Important
Comfort
1
2
3
Affordability
4
5
6
Ease of use
7
8
9
Eye health/safety
10
11
12
Long wearing time
13
14
15
On a scale of 1 to 5, how sensitive are your eyes? (1 = Not sensitive, 5 = Very sensitive)
*
Not sensitive
1
2
3
4
Very sensitive
5
1 is Not sensitive, 5 is Very sensitive
Is there anything else you'd like us to know about your vision or preferences?
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