Customer Satisfaction Survey

SEFT-TEST FORM

Dry eye disease is a common and uncomfortable condition, yet it often goes undiagnosed. If you’re experiencing dry eye symptoms, complete this self-test form to see if you meet the requirements for diagnosis.

Your Name(Required)

First Last

Have you experienced dryness, grittiness or scratchiness in your eyes in the last 30 days?

Yes

No

Do your eyes often feel sore or irritated?

Yes

No

Have you experienced your eyes burning or watering in the last 30 days?

Yes

No

Do your eyes feel tired or fatigued?

Yes

No

Enter your email for more information about dry eye and how the experts at Envision Eye Care can help you feel (and see) better!(Required)

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CALL US NOW

Marion: 276-262-6464

Cedar bluff: 276-218-3210

Bristol: 423-418-5513

Abingdon: 276-262-6383

Due to CDC guidelines, we will only be seeing emergency eye patients at this time. Please call our office if you have an eye emergency. Thank you for understanding

Call Marion Office 276-521-4446

Call Cedar Bluff Office 276-991-3171

Call Bristol Office 423-546-4536

Monday:	8:00 AM - 5:00 PM
Tuesday:	8:00 AM - 5:00 PM
Wednesday:	8:00 AM - 12:00 PM 2:00 PM - 5:00 PM
Thursday:	8:00 AM - 5:00 PM
Friday:	8:00 AM - 5:00 PM
Saturday:	Closed
Sunday:	Closed

Monday:	8:00 AM - 5:00 PM
Tuesday:	8:00 AM - 5:00 PM
Wednesday:	8:00 AM - 12:00 PM 2:00 PM - 5:00 PM
Thursday:	8:00 AM - 5:00 PM
Friday:	8:00 AM - 5:00 PM
Saturday:	Closed
Sunday:	Closed

Monday:	8:00 AM - 5:00 PM
Tuesday:	8:00 AM - 5:00 PM
Wednesday:	8:00 AM - 12:00 PM 2:00 PM - 5:00 PM
Thursday:	8:00 AM - 5:00 PM
Friday:	8:00 AM - 5:00 PM
Saturday:	Closed
Sunday:	Closed

Monday:	8:00 AM - 5:00 PM
Tuesday:	8:00 AM - 5:00 PM
Wednesday:	8:00 AM - 12:00 PM 2:00 PM - 5:00 PM
Thursday:	8:00 AM - 5:00 PM
Friday:	8:00 AM - 5:00 PM
Saturday:	Closed
Sunday:	Closed

Monday:	8:00 AM - 5:00 PM
Tuesday:	8:00 AM - 5:00 PM
Wednesday:	8:00 AM - 12:00 PM 2:00 PM - 5:00 PM
Thursday:	8:00 AM - 5:00 PM
Friday:	8:00 AM - 5:00 PM
Saturday:	Closed
Sunday:	Closed

Please let us know how your last visit went.

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Marion, VA Office

Cedar Bluff, VA Office

Bristol, TN Office

Abingdon, VA Office

Gray, TN Office

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Marion, VA

Cedar Bluff, VA

Bristol, TN

Abingdon, VA

Gray, TN

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