Questionnaire for dark circles and puffy eyes adds in questions related dark circles and puffy eyes and how to maintain brighter eyes which are answered by experts and dark circles and puffy eyes victims and dermatologists, whose reaction helps eye care, manufactures to recognize the problems and results of their products and improve the existing and new and better eye care products.



Sample Questionnaire For Dark Circles And Puffy Eyes:


Fill your details:

Name: ________________
Gender: _______________
How old are you:  ________________
Area/ district you live: ______________

Queries:

Do you have dark under eyes?
a)Yes b) no c) some times


What is your hemoglobin percentage?
a)Below 13 b) 13 c) above 13

How many hours a day you sleep?
Specify your answer: ________________

Did you apply any under eye creams to get rid of dark circles?
a) Yes b) no c) some times

What is the percentage or depth of darkness around your eyes?
Specify your answer: ________________

Which type of eyes you have
a)Dry b) wet c) normal d) any other___________

Did you try any eye exercises to get rid of dark under eyes?
a) Yes b) no c) sometimes   d) if yes which exercise __________

Did you consult any dermatologist for this dark circle, puffy eyes issue?
a)Yes b) no

Do you have a habit of rubbing your eyes?
a)Yes b) no c) sometimes

From how many days you are suffering from dark circle/ puffy eyes or both?
Specify your answer: ________________

Do you have a habit of eating a salty dinner?
a)Yes b) no c) sometimes

Do you have sinus infection or cold, seasonal allergies?
a)Yes b) no c) sometimes

Do you have a habit of sleeping on your stomach?
a)Yes b) no c) sometimes

Do you have a habit of falling asleep with makeup?
a)Yes b) no c) sometimes

Are you feeling tiered every day?
a)Yes b) no c) sometimes

Do you have any genetic disorder regarding lack of sleep?
a)Yes b) no c) don’t know

Do you have blue or brown under eye circles?
Specify your answer____________

Do you have a habit of roaming in hot sun?
a)Yes b) no c) sometimes

Do you have a habit of applying sunscreen lotion which protects your eyes?
a)Yes b) no c) sometimes

Would you like to cover your dark circles with concealer?
a)Yes b) no c) sometimes

Which concealer you use?
Specify your answer____________

What type of skin you have around your eyes?
a)Thin b) thick c) normal d) any other answer _____________

What all experiments you did to get rid of dark circles / puffy eyes?
Specify your answer____________