Skip to main content
Shop
Online
chat-bubbles Call/Text Burnaby:
604-777-7577
Request An Appointment
Burnaby
chat-bubbles Call/Text Vancouver:
604-777-7579
Request An Appointment
Vancouver

glasses
Home » Eye Care Services » DEQ-5 Questionnaire

DEQ-5 Questionnaire

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?

  • 2. Do you experience EYE DRYNESS?

  • 3. Do you have WATERY EYES?

  • This field is hidden when viewing the form