STEP 1 OF 3

Do You Use Eye Drops Everyday?

• Yes
•  
• No

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STEP 2 OF 3

What Level Of Dry Eyes Are You Experiencing?

• Seasonal Dry Eye Allergies
• Mild Dry Eye
• Severe Dry Eye

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STEP 3 OF 3

Are You Experiencing Any Of The Following (check all that apply):

• Scratchy, Gritty, or Irritated Feeling
• Eye Pain or Stinging
• Sensitivity To Light
• Blurred Vision
• Redness
• Eye Strain or Fatigue

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