Evaluation Card

It was great seeing you at your last appointment. Our mission is to provide you with the absolute best vision and eye care possible. Your feedback is very important to us and we appreciate you taking a moment to help us enhance our service by filling out our short survey.

We would appreciate your assistance in completing the following questions, to help us better serve your eye care needs. Mark the box next to your answer:

Was our staff courteous and helpful?

Were you seen in a timely manner?

Was your examination thorough?

Were you satisfied with the explanation of your visual conditions and treatment options?

If fit with contact lenses or glasses, did the service and quality meet your expectations?

Would you refer a friend to our office for eye care?

How would you rate your overall satisfaction with our office? (On Scale of 1 being Poor to 10 being Excellent)

Please mention at least one aspect of our services that we could improve upon:

Other Comments: