Form Test

Your age?
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How much do your regular prescription glasses and sun glasses cost? If you only have contacts enter $0.
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On Average, how many years between new pairs of glasses?
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When visiting the eye doctor what is your normal co-pay
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How many years between visits to the eye doctor?
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On Average, how many boxes of contacts do you use in a year?
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How much do you pay per box of contact lenses?
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How many bottles of contact cleaning solution do you use per year?
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How much does a bottle of your contact cleaning solution cost?
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$0.00
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