Survey
FORM-1182 We appreciate any feedback you have on the services our clinic provides. Please fill out the survey below.
Name Email Address 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) Please let us know how we may improve your experience in our office: If you have suggestions on how we can make your future experience better, please contact our Office Manager, Wendy. Email or call 763-428-3757. |