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Home
About
Meet Our Doctors
Meet Our Staff
Optical Services
Primary Eye Care
Spectacle Frame Services
Lens Services
Contact Lenses
Ocular Disease
Ocular Trauma
Pediatric Vision Care
Vision Therapy
Optomap Ultra-widefield Photography
Contact Us
Make An Appointment
Hours & Directions
Your Visit
What to Bring/What to Expect
Patient Forms
Patient Satisfaction Survey
Make An Appointment
Pay My Bill
Other Resources
Website Links
Patient Satisfaction Survey
Please evaluate your recent eyecare experience at our office.
Wait Time
5 - Extremely Satisfied
4 - Satisfied
3 - Neutral
2 - Dissatisfied
1 - Extremely Dissatisfied
0 - Not Applicable
Office Appearance
5 - Extremely Satisfied
4 - Satisfied
3 - Neutral
2 - Dissatisfied
1 - Extremely Dissatisfied
0 - Not Applicable
Front Office Staff
5 - Extremely Satisfied
4 - Satisfied
3 - Neutral
2 - Dissatisfied
1 - Extremely Dissatisfied
0 - Not Applicable
Name of Front Staff Personnel
Doctor
5 - Extremely Satisfied
4 - Satisfied
3 - Neutral
2 - Dissatisfied
1 - Extremely Dissatisfied
0 - Not Applicable
Name of Your Doctor
Contact Lens Technician
5 - Extremely Satisfied
4 - Satisfied
3 - Neutral
2 - Dissatisfied
1 - Extremely Dissatisfied
0 - Not Applicable
Name of Your Contact Lens Technician
Optician
5 - Extremely Satisfied
4 - Satisfied
3 - Neutral
2 - Dissatisfied
1 - Extremely Dissatisfied
0 - Not Applicable
Name of Your Optician
Eyewear Selection
5 - Extremely Satisfied
4 - Satisfied
3 - Neutral
2 - Dissatisfied
1 - Extremely Dissatisfied
0 - Not Applicable
Overall Experience
5 - Extremely Satisfied
4 - Satisfied
3 - Neutral
2 - Dissatisfied
1 - Extremely Dissatisfied
0 - Not Applicable
We appreciate any comments or testimonials.
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Do we have permission to use your feedback as a testimonial for marketing purposes?
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