Skip to main content
REFER A PATIENT
Patient Portal
Call Today
Book Now
About
Our Proven Process
Our Doctors
Chris Morris, O.D.
Alex Bell, O.D.
Belinda R. Starkey, O.D.
Emily Hines, O.D.
Jennifer Dillard, O.D.
Our Blog
Community Involvement
Eye Care Services
Comprehensive Eye Exams
Contact Lens Exams
Pediatric Eye Exams
Diabetic Eye Exams
Myopia Management
Eye Disease Treatment
Age-Related Macular Degeneration (AMD)
Cataract Treatment
Glaucoma Management
Keratoconus & Scleral Lenses
Low Vision
Dry Eye Treatment
IPL Treatment
LLLT
Forma-I
Aesthetics
Forma Face Treatment
Morpheus 8 Treatment
Xeomin
Eyewear
Neurolens
Nuance Audio
Browse our Eyewear
Patient Resources
Patient Forms
Pay Bill Now
Order Contacts
Buy Dry Eye Products
Shop Skincare
Insurance & Financing
Our Locations
Rogers
Bentonville
Contact Us
Open Menu
MENU
Close Menu
About
Our Proven Process
Our Doctors
Chris Morris, O.D.
Alex Bell, O.D.
Belinda R. Starkey, O.D.
Emily Hines, O.D.
Jennifer Dillard, O.D.
Our Blog
Community Involvement
Eye Care Services
Comprehensive Eye Exams
Contact Lens Exams
Pediatric Eye Exams
Diabetic Eye Exams
Myopia Management
Eye Disease Treatment
Age-Related Macular Degeneration (AMD)
Cataract Treatment
Glaucoma Management
Keratoconus & Scleral Lenses
Low Vision
Dry Eye Treatment
IPL Treatment
LLLT
Forma-I
Aesthetics
Forma Face Treatment
Morpheus 8 Treatment
Xeomin
Eyewear
Neurolens
Nuance Audio
Browse our Eyewear
Patient Resources
Patient Forms
Pay Bill Now
Order Contacts
Buy Dry Eye Products
Shop Skincare
Insurance & Financing
Our Locations
Rogers
Bentonville
Contact Us
Return to top of menu
About
Our Proven Process
Our Doctors
Chris Morris, O.D.
Alex Bell, O.D.
Belinda R. Starkey, O.D.
Emily Hines, O.D.
Jennifer Dillard, O.D.
Our Blog
Community Involvement
Eye Care Services
Comprehensive Eye Exams
Contact Lens Exams
Pediatric Eye Exams
Diabetic Eye Exams
Myopia Management
Eye Disease Treatment
Age-Related Macular Degeneration (AMD)
Cataract Treatment
Glaucoma Management
Keratoconus & Scleral Lenses
Low Vision
Dry Eye Treatment
IPL Treatment
LLLT
Forma-I
Aesthetics
Forma Face Treatment
Morpheus 8 Treatment
Xeomin
Eyewear
Neurolens
Nuance Audio
Browse our Eyewear
Patient Resources
Patient Forms
Pay Bill Now
Order Contacts
Buy Dry Eye Products
Shop Skincare
Insurance & Financing
Our Locations
Rogers
Bentonville
Contact Us
Open Menu
Close Menu
About
Our Proven Process
Our Doctors
Chris Morris, O.D.
Alex Bell, O.D.
Belinda R. Starkey, O.D.
Emily Hines, O.D.
Jennifer Dillard, O.D.
Our Blog
Community Involvement
Eye Care Services
Comprehensive Eye Exams
Contact Lens Exams
Pediatric Eye Exams
Diabetic Eye Exams
Myopia Management
Eye Disease Treatment
Age-Related Macular Degeneration (AMD)
Cataract Treatment
Glaucoma Management
Keratoconus & Scleral Lenses
Low Vision
Dry Eye Treatment
IPL Treatment
LLLT
Forma-I
Aesthetics
Forma Face Treatment
Morpheus 8 Treatment
Xeomin
Eyewear
Neurolens
Nuance Audio
Browse our Eyewear
Patient Resources
Patient Forms
Pay Bill Now
Order Contacts
Buy Dry Eye Products
Shop Skincare
Insurance & Financing
Our Locations
Rogers
Bentonville
Contact Us
Return to top of menu
Refer a Patient
BOOK AN APPOINTMENT
Home
»
»
3-9.jpg
3-9.jpg
Call a Location
Call One of Our Convenient Locations
Rogers (479) 349-0518
Bentonville (479) 383-2430
Find Out if Neurolens is Right for You, Take Our Short Questionnaire
On a scale of 1-5 (1 being never and 5 being always) how true is this statement for you:
I experience headaches of any severity each week, usually getting worse later in the day
1
2
3
4
5
I experience stiffness or pain in my neck or shoulders when I work at a computer or read
1
2
3
4
5
I experience discomfort with computer use in my eyes (redness, burning) after long hours looking at the screen
1
2
3
4
5
I experience tired eyes with increasing feeling of eye fatigue throughout the day
1
2
3
4
5
I have a dry eye feeling progressively more gritty/sandy while working at the computer or reading
1
2
3
4
5
I experience light sensitivity especially with brighter, stronger lights like flourescents or headlights
1
2
3
4
5
I have dizziness or experience motion sickness or vertigo
1
2
3
4
5
Name
Email
Phone
Phone
This field is for validation purposes and should be left unchanged.
Δ
