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LASIK
Your opinions and observations are important to us. Please take a few minutes to provide us with your insights and suggestions.
Patient Satisfaction Survey
Your Email Address (optional)
Was there any one person that made your visit easier or more enjoyable?
Was there any one service that made your visit easier or better?
How can we improve?
Would you refer your friends and family? Why or Why not?
Were you greeted in a prompt, friendly and courteous manner?
4 Great
3 Good
2 Fair
1 Poor
Telephone questions answered accurately.
4 Great
3 Good
2 Fair
1 Poor
Realistic wait to see the doctor.
4 Great
3 Good
2 Fair
1 Poor
Office organization and cleanliness.
4 Great
3 Good
2 Fair
1 Poor
Thoroughness of eye examination.
4 Great
3 Good
2 Fair
1 Poor
Did the Doctor answer your questions?
4 Great
3 Good
2 Fair
1 Poor
Contact lens instructions and agreement
4 Great
3 Good
2 Fair
1 Poor
Satisfied with your glasses selection?
4 Great
3 Good
2 Fair
1 Poor
Ease of insurance procedures
4 Great
3 Good
2 Fair
1 Poor
Efficiency of checkout services.
4 Great
3 Good
2 Fair
1 Poor
How would you rate your experience?
4 Great
3 Good
2 Fair
1 Poor
Thank you!