AMERICA
-
ASIA
-
EUROPE
<<< HOME
Corporate Profile
Menicon lenses
Menicon Care
Menicon Worldwide
Registration
Health
GO TO PROFESSIONAL AREA
" By registering here you will receive news from Menicon "
Name: *
Surname: *
Address: *
Postal code:
City: *
Country:
Email: *
Age: *
choose one
< 16
16 - 19
20 - 29
30 - 39
40 - 49
50 -59
> 60
Do you want to receive Menicon´s e-letter:
Yes
No
I would like to receive the information in:
English
Spanish
German
French
Gender
choose one
Male
Female
** Vision problem:
Myopic
Hypermetropic
Astigmate
Presbyopic
** For multiple selections, press Control + Click on the different choices (Command + Click on Macintosh)
Other vision problems not listed above:
Are you currently wearing contact lenses?
choose one
Yes
No
If your answer is yes, I wear contact lenses,please, fill the questions below
Are you a new contact lens wearers?
choose one
Yes
No
Do you currently wear contact lenses?
choose one
Yes
No
Contact lens type
choose one
Rigid gas permeable contact lenses
Daily disposable contact lenses
Weekly or bi-weekly contact lenses
Monthly contact lenses
Traditional soft contact lenses
Do you know your lens brandname?
Which care product do you use?
Do you sleep in your lenses?
choose one
Yes
No
If your answered yes above, please fill the following question below
How often?
choose one
Sometimes
~ 7 nights
~ 30 nights
Yes, I agree with
Menicon´s Private Policy
*
(*) Required fields
