Diva of the week questionnaire

Congratulations!!!

You have been selected as a Diva of the week, an honor reserved only for Elite Divas and Ambassadors!!!

The purpose of this feature is to promote you, your products and to give you a platform to inspire others. By submitting this form, you are helping us fulfill our mission to Empower, Connect and Promote the success of women ODs.

Diva of the week questionnaire

Please answer the following questions to help us complete your feature.

Name*
First Last Suffix
Email*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Website
Business Facebook Profile Link
Personal Facebook Profile Link
LinkedIn Profile Link
Twitter Profile Link
Instagram Profile Name
1. Tell us a little bit about you?*
Ex. Tell us where you're from, if you're married, single, have kids. Something unique you like about yourself. Tell us about a favorite thing you like to do.
2. What made you decide to become in Optometrist?*
3. What Optometry school did you go to?*
4. Where do you currently practice?*
5. Do you offer any specialty services in your practice?*
6. Name 1 to 3 hurdles you personally faced in your career and how did you overcome them?*
7. If you could go back to when you were a student, what advice would you give yourself?*
Do you have a product or side business you'd like for us to include in your feature? If so, write a brief description of the product and/or service below plus the link where the readers can learn more about it.
Please upload a heashot pic of yourself below to be used for the feature.
Accepted file types: jpeg, gif, png, pdf, jpg, Max. file size: 128 MB.
If you get an error uploading the file, you may email it directly to us at info@OptometryDivas.com.
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Your privacy is important to us. To better protect your privacy we provide this notice explaining our online information practices and the choices you can make about the way your information is collected and used. To make this notice easy to find, we make it available on our homepage and at every point where personally identifiable information may be requested.

Please refer to our homepage footer for the full policy.

Diva of the week questionnaire

Congratulations!!!

You have been selected as a Diva of the week, an honor reserved only for Elite Divas and Ambassadors!!!

The purpose of this feature is to promote you, your products and to give you a platform to inspire others. By submitting this form, you are helping us fulfill our mission to Empower, Connect and Promote the success of women ODs.

Diva of the week questionnaire

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