Satisfaction Survey

Let us know how we’ve helped you so far on your way to better eye care. We want to make sure that everyone sees the best service possible.

Service Ratings

Communication Prior to Appointment

Appointment Availability

Waiting Room Time


Quality of Care from Staff

Quality of Care from Doctor

Concerns or Questions Answered

Overall Quality of Care


Preferred Day for Appointments

Preferred Time for Appointments

Do you plan on returning for your next comprehensive examination?

Would you schedule appointments online?


Satisfaction with Eyeglasses

Satisfaction with Contact Lenses

Range of Eyeglass Selection

Identification (optional)

Why did you choose us for your eye health care?

Your Name (optional)

Additional Comments

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