Patient Satisfaction Survey We are always doing our best to improve and we carefully review all of the input we receive. Please let us know how your last visit went.Service RatingsCommunication prior to appointmentGreatGoodFairPoorN/AAppointment availabilityGreatGoodFairPoorN/AWaiting room timeGreatGoodFairPoorN/AFeesGreatGoodFairPoorN/AQuality of care from staffGreatGoodFairPoorN/AQuality of care from doctorGreatGoodFairPoorN/AConcerns or questions answeredGreatGoodFairPoorN/AOverall quality of careGreatGoodFairPoorN/ASchedulingPreferred day for appointmentsSundayMondayTuesdayWednesdayThursdayFridaySaturdayNo preferencePreferred time for appointments7 am to 9 am9 am to 5 pm5 pm to 8 pm8 pm to 10 pmNo preferenceDo you plan on returning for your next comprehensive examination?YesNoPlease tell us why notWould you schedule appointments online?YesNoPlease tell us why notProductsSatisfaction with eyeglassesGreatGoodFairPoorN/ASatisfaction with contact lensesGreatGoodFairPoorN/ARange of eyeglasses selectionGoodToo FewToo ManyToo many of the same typeIdentification - This section is optional.Why did you choose us for your eye health care?Your Name (Optional) First Last Additional commentsCommentsThis field is for validation purposes and should be left unchanged.
