We appreciate any feedback you have on the services our clinic provides. Please fill out the survey below.

Was our staff courteous and helpful? YesNo
Were you seen in a timely manner? YesNo
Was your examination thorough? YesNo
Were you able to understand your eye condition and treatment options? YesNo
Will you refer other patients to our office? YesNo
How would you rate your overall satisfaction with our office? 12345
(1=very dissatisfied, 5=exceeding expectations)

If you would like to give us additional feedback, please contact Cheri at 763-428-3757.