A message from Dr. Larry Wan and VISTAKON®

Take a Brief Survey!

Please take a moment to answer the questions in our brief survey. Your responses will help us develop new programs and interactive features to better serve your needs. Everyone who participates in this survey will receive a free umbrella as our way of saying thank you.

Your responses to these questions are optional. They will be combined with responses from others and used in the aggregate to help us evaluate this program. The responses will not be used with information that will identify you personally.

By submitting your information you agree that it will be governed by our privacy policy.

All fields are required in order to receive your Umbrella!


1. Overall, how would you rate this video e-mail?

Excellent
Very good
Good
Fair
Poor
2. How relevant to you was the information in this video e-mail?
Very relevant
Somewhat relevant
Not at all relevant
3. How credible was the speaker in this video e-mail?
Very credible
Somewhat credible
Not at all credible
4. Are you likely to fit ACUVUE® Brand BIFOCAL Contact Lenses more often based on viewing this video e-mail?
Yes
No
5. In an average week, how many bifocal contact lens fits do you currently perform?
None
1-10
11-20
More than 20
6. What is your bifocal lens of choice?
ACUVUE® BIFOCAL
Additions
Focus Progressives
Focus DAILIES Progressives
RGP
Other Specify:



Please enter the following information to be able to receive your Free Umbrella!

Name:
Address 1:
Address 2:
City:      State:       Zip:
Phone:
Email:

Note: Focus Dailies and Focus Dailies Progressives are registered trademarks of Ciba Vision Inc.



Problems with Video Player?
View Video Online!

Take a brief survey *
Forward to a friend
View Dr. Wans Biography
Visit www.acuvue.com
Online CE!

*
Free ACUVUE®
Premium Item!


 

If you no longer would like to receive email messages from Boucher Communications, Inc., please use the link below to have your email address removed: Removal Request | View BCI's Privacy Policy