Skip to main content

Offices located in Americus and Leesburg, GA.

Open Menu
OPEN MENU
Pay Your Bill Online
Patient Registration
Schedule Appointment
Call Americus Office 229-518-3040
Call Leesburg Office 229-792-8887
Home » DEQ-5 Questionnaire

DEQ-5 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?

  • 2. Do you experience EYE DRYNESS?

  • 3. Do you have WATERY EYES?

  • This field is hidden when viewing the form

Call Americus 229-252-7714

Call Leesburg 229-252-7711