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View our eyewear...
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Steel & Varley Pre-test Patient Questionnaire
Reason for Visit
Tick one or more...
Eye health concern
Change in vision
Want new glasses
Responding to recall
Interested in contact lenses
What glasses do you currently wear?
Single Vision Distance
Single Vision Reading or Computer
I don't wear glasses
Tell us about your glasses wear (if applicable). Do you...
Get any sight problems at night?
Are you sensitive to light?
Have a spare pair?
Have problems with the sun or reflections off surfaces, such as a wet road?
Have any problems with painful pressure marks on your nose caused by your glasses?
Have problems with your glasses slippping down your nose?
Fancy a new pair/change of style?
Have you noticed any problems with your hearing?
Thanks for submitting!
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