Save Your Vision Month Survey

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* Indicates required question

Email *

Record my email address with my response

How much time do you spend in front of a digital device (computer, smartphone, tablet, etc.)

Less than an hour a day

1-3 hours

4-6 hours

7-10 hours

More than 10 hours a day

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When was the last time you had an eye screening?

Within the last month

Within the last six months

Six months to a year

Within the last 1-2 years

More than two years ago

Clear selection

Submit

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