Family EyeCare Center is now Greenway Vision Studio
— same doctor, same team, same location, same number: (919) 729-6207 
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Lifestyle Questionnaire

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This questionnaire is designed to assist your eye doctor in prescribing you the perfect lenses, frames and/or contacts to suit your visual needs and lifestyle. Please take a few moments to answer the following questions.

1. Which of the following visual demands do you encounter on a regular basis?
Check all that apply.
2. Which of the following hobbies or activities do you participate in?
Check all that apply.

3. How much screen time do you use?

Screen activities
Check all that apply and list the number of hours per day below.
4. Do your eyes seem bothered by glare from any of the following situations?
Check all that apply.
5. If you wear contacts, do you have any of the following?
Check all that apply.