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Our Eye Doctors
Dry Eye Testimonials
Causes of Dry Eyes
Dry Eye Treatments
Eye Care Services
Eyeglasses
Contact Lenses
About Us
- Hours & Location
- Insurance

Home » Eye Care Services » Dry Eye » Dry Eye Questionnaire

Dry Eye 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?
a. During a typical day in the past month, how often did your eyes feel discomfort?*
- Never
- Rarely
- Sometimes
- Frequently
- Constantly
b. When your eyes felt discomfort, how intense was this feeling of discomfort at the end of the day, within two hours of going to bed?*
- Never
- Rarely
- Sometimes
- Frequently
- Constantly
2. Do you experience EYE DRYNESS?
a. During a typical day in the past month, how often did your eyes feel dry?*
- Never
- Rarely
- Sometimes
- Frequently
- Constantly
b. When your eyes felt dry, how intense was this feeling of dryness at the end of the day, within two hours of going to bed?*
- Never
- Rarely
- Sometimes
- Frequently
- Constantly
3. Do you have WATERY EYES?
During a typical day in the past month, how often did your eyes look or feel excessively watery?*
- Never
- Rarely
- Sometimes
- Frequently
- Constantly
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Total Focus Northgate and Dry Eye Clinic

9499 137 Ave NW # 1100
Edmonton, AB T5E 5R8

Phone: 780-472-7740
Email: info@totalfocusnorthgate.com
(Do not send personal health information by email.)

Monday: 10:00 AM - 6:00 PM
Tuesday: 10:00 AM - 6:00 PM
Wednesday: 10:00 AM - 6:00 PM
Thursday: 10:00 AM - 9:00 PM
Friday: 10:00 AM - 6:00 PM
Saturday: 10:00 AM - 6:00 PM
Sunday: 12:00 PM - 4:00 PM

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Contact Us
What’s New
Disclaimer
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Schedule Appointment

Speak Field

Total Focus Northgate and Dry Eye Clinic
9499 137 Ave NW # 1100
Edmonton, AB T5E 5R8
Phone: 780-472-7740
https://www.totalfocusnorthgate.com

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See What's New at Total Focus Northgate and Dry Eye Clinic!

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Do you experience dry eyes?
Speak to us about our successful IPL treatment!

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We now supply PRP eye drops to treat dry eyes

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