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Speed Questionnaire

For the Standardized Patient Evaluation of Eye Dryness (SPEED) Questionnaire, please answer the following questions by checking the box that best represents your answer. Select only one answer per question.

1. Report the type of SYMPTOMS you experience and when they occur:

Dryness, Grittiness or Scratchiness
Soreness or Irritation
Burning or Watering
Eye Fatigue
Do you use eye drops for lubrication?

Add your name, phone number and email address to see your results:

New or returning patient?

Thanks for submitting!

Call us today or visit our appointment request
page to find a time that is convenient for your next appointment at Nostalgic Dry Eye Spa!

Contact Us

6656 Germantown Ave Suite 1

Philadelphia, PA, 19119

Phone: 215-842-5939

Fax: 215-842-5937

NEC@nostalgiceyecare.com

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Office Hours

Monday​9am - 5pm

Tuesday: 11am - 7pm

Wednesday: 9am - 5pm

Thursday: 11am - 7pm

Friday: 9am - 3pm

Saturday: Closed

Sunday: Closed

©Nostalgic Dry Eye Spa. By Design With Artisan.

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