Answer the following questions

Mandatory to answer all the questions

Name:

Place of Practice:

Average OPD:

In-house Dispensing

Prescriber

Mobile Number:

E-mail Id:

Name of MR that visits you from Raymed (if Any):

Q1. Do you believe that Eyelid Hygiene can improve Dry Eye, Meibomian gland dysfunction (MGD) & Demodex Blepharitis problem *

Yes
No

Q2.Do you Rx any product for improving eyelid hygiene to your patients *

Yes
No

Q3. Are you aware about the role of Tea Tree Oil & Sodium Hyaluronate in Blepharitis and MGD treatment *

Yes
No

Q4. Would you like to try our Eyelid Hygiene Range *

Yes
No

Q5.Do you Rx Atropine Sulphate 0.01% eye drops to your paediatric patients *

Yes
No

Q6. If yes, how many eye drops do you prescribe in a month? *

0-5
5-10 10-20
More than 20

Q7. Do you Rx Nepafenac 0.1% eye drops for pain and inflammation to your patients *

Yes
No

Q8. If yes, what is the preferred composition? *

Clear Solution
Suspension

Q9.What will you prefer in pain and inflammation *

Once daily dose of 0.3% Nepafenac
Three times dose of 0.1% Nepafenac in pain

Q10. Which is your favorite brand of Raymed?*