1. Full Name (as per Student ID)
2. Gender
Male
Female
3. Student ID
4. Mobile Number (Example: 60123334444)
5. Email
6. Power (left eye). Please only indicate a negative power, between -0.50 to -12.00
Select an option
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
-4.25
-4.50
-4.75
-5.00
-5.25
-5.50
-5.75
-6.00
-6.50
-7.00
-7.50
-8.00
-8.50
-9.00
-9.50
-10.00
-10.50
-11.00
-11.50
-12.00
7. Power (right eye). Please only indicate a negative power, between -0.50 to -12.00
Select an option
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
-4.25
-4.50
-4.75
-5.00
-5.25
-5.50
-5.75
-6.00
-6.50
-7.00
-7.50
-8.00
-8.50
-9.00
-9.50
-10.00
-10.50
-11.00
-11.50
-12.00
8. Have you participated in Alcon Water Surface Lens Campus Roadshow in 2025?
Yes
No
9. Do you wear Contact Lens or Spectacles?
Contact Lens only
Spectacles only
I wear both contact lens and spectacles
10. Do you have astigmatism (散光/silau)?
Yes
No
11. Are you wearing contact lens with astigmatism powers?
Yes
No
I do not wear contact lenses
12. Do you wear Daily or Monthly contact lenses?
Daily
Monthly
I wear both daily and monthly contact lenses
I do not wear contact lenses
13. What is the brand of Contact Lense you are currently wearing?
Your browser does not support the video tag.
14. Based on the video, PRECISION1™, DAILIES TOTAL1™ & TOTAL30™ has innovative water surface technology?
Yes, PRECISION1™, DAILIES TOTAL1™ & TOTAL30™ has innovative water surface technology.
True
True
False
15. Where do you usually purchase your contact lenses?
Online
Physical outlets
-Select-
FOCUS POINT
MOG
A-LOOK
SEEN
OTHERS
I do not wear contact lenses
16. It's okay to send me email communication about Alcon WaterInnovations Campus Roadshow from the event organiser on behalf of Alcon. I can opt out at any time if I decide I no longer wish to receive communications.
Yes, I consent
No, I do not consent
Submit
