Thank you for your recent visit to our office! We would appreciate your assistance in completing the following questions in order to help us better serve your eye care needs.

Was our staff courteous and helpful? Yes   No  
Were you seen in a timely manner? Yes   No  
Was your examination thorough? Yes   No  
Were you satisfied with the explanation of your visual conditions and treatment options? Yes   No  
If fit with contact lenses or glasses, did the service and product quality meet your expectations? Yes   No  
Would you refer a friend to our office for eye care? Yes   No  
How would you rate your overall experience with our office?
Exceeded my expectations
Room for Improvement
Other comments:

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