AJAX EYE CARE

Quality of Life Survey - Symptom Severity

This survey will help evaluate how severe you feel your symptoms are and if you should be seeking the assistance of a Developmental Optometrist. Survey questions adopted from the College of Optometrists in Vision Development. [https://www.covd.org]

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To have your result emailed to you, please input your information below. *Email and Phone are not mandatory*

Quality of Life Survey – Symptom Severity