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Home » Contact Us » Satisfaction Survey

Satisfaction Survey

  • Please support us in providing excellent service to our patients by filling out the survey below. Then, stop by our office to receive your free bottle of premium lens cleaner.
  • Doctor

  • Evaluate the following statements.
    Communication Prior to Appointment
    Waiting Room Time
    Quality of Care from Staff
    Quality of Care from Doctor
    Overall Experience
    Frame Selection
    Lens Options
    Satisfaction with Eyeglasses
    Satisfaction with Contact Lenses