Patient Satisfaction Survey
Answers marked with a * are required.
1. About Our Services
  Thank you for choosing our practice for your eyecare. Your satisfaction with the services we provide is important to us. Please complete this short survery and let us know how we might further enhance your experience.
 
1. The convenience of our office hours *
      
 
 
 
2. The ease of making your appointment *
      
 
 
 
3. The friendliness/helpfulness of our front desk staff *
      
 
 
 
4. The comfort and cleanliness of the office *
      
 
 
 
5. Knowledge/Friendliness of the Technicians *
      
 
 
 
6. The thoroughness of the care recieved *
      
 
 
 
7. The clarity of our explanation about procedures and treatments *
      
 
 
 
8. Our willingness to listen to your concerns/questions *
      
 
 
 
9. The quantity of time spent with you *
      
 
 
 
10. The Doctor's friendliness and courtesy *
      
 
 
 
11. Help with understanding your insurance coverage (if applicable) *
      
 
 
 
12. The length of time you waited to see the doctor *
      
 
 
 
13. The overall satisfaction with your visit *
      
 
 
 
 
 

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