Seven Question Survey for Dyslexia Lenses
Answer the following questions to the best of your ability:
1
Do you have double-vision when reading?
Never
Infrequently
Sometimes
Often
Always
2
Do you notice words or sentences that are blurry or wiggly when reading?
Never
Infrequently
Sometimes
Often
Always
3
Do you see words or sentences that come in and out of focus when reading?
Never
Infrequently
Sometimes
Often
Always
4
Do the words "pop out" at you when reading?
Never
Infrequently
Sometimes
Often
Always
5
Do the words "scrunch together" or "pull apart" when reading?
Never
Infrequently
Sometimes
Often
Always
6
Do the words move from side-to-side or up-and-down when reading?
Never
Infrequently
Sometimes
Often
Always
7
Do the words move, jump, swim, or appear to float when reading?
Never
Infrequently
Sometimes
Often
Always
Your Information
Parent
Patient
Select State
Georgia
How Did You Hear About Us?
Search Engine (Google, Bing, etc.)
Social Media (Facebook, Instagram, etc.)
YouTube
TikTok
Friend or Family Member
Doctor or Therapist
School or Teacher
News Article or Blog
Other