Online Personal Assessment Survey

For your first visit, I will need to know what you are experiencing.  The online survey will guide you through a process whereby we can assess and track your symptoms. The questionnaires will help me create your personal treatment plan.  There are two ways you can fill out the survey, online at home or in my office as part of your initial consultation.  I will give you the username format that I use for the survey.

At home, Click on the Online LENS Forms link below and fill out the online questionnaires.   The questionnaires consist of three parts: (1) CNS Questionnaire, (2) Intake Form, and the (3) Sensitivity Questionnaire.  Once submitted, this information will help me understand your physiological presentation.  When you take the time to fill out the survey it will give  information on your best course of treatment.  it will also build a baseline so we can trace your progress through the LENS treatment cycle. Please be thoughtful in your answers, they will be useful in understanding the scope of your condition.  There are no right or wrong answers, just helpful information.