SPEED™ Questionnaire Results

Name: Coleman Vision Center
Address: 1030 SE Murphy Blvd, Joplin, MO, 64801-5043, US
Price range: $000 - $300

Thank you for completing the SPEED Questionnaire!
This assessment is your first step toward finding relief from dry eye.
Your Score:
If your score is:
0-4 you are experiencing MILD dry eye symptoms
5-7 you are experiencing MODERATE dry eye symptoms
8+ you are experiencing SEVERE dry eye symptoms

The SPEED Questionnaire is one tool we use to help assess your dry eye symptoms. No matter what you scored on the quiz, we take your overall eye health very seriously. Please complete the information below and our office will contact you to schedule a dry eye evaluation.
Would you like our practice to contact you to schedule a dry eye evaluation?
- Yes
- No
Would you be interested in receiving information about dry eye treatment, dry eye prevention and more?
- Yes
- No

Section 1: Referring Healthcare Provider