Patient Satisfaction Survey

The doctor and staff at Advanced Vision Care would like to thank you for helping us with this survey.
Our mission is to stay at the forefront of our profession and your input regarding our services and products is greatly appreciated.

It is optional to enter your name and email address below.
If you do, your name will be entered into a monthly drawing for a gift card to Applebee's!
*Your email address will be treated with respect. It will be used soley for the purpose of announcing to the winner that he/she has won the monthly drawing. No email addresses will ever be sold or given to third parties.
*Only one entry per name will be eligible for each monthly drawing .

    Outstanding Above Average Average Fair Poor Not Applicable
1 How knowledgeable and helpful was the telephone staff?
2 Were you able to schedule an appointment within a reasonable time period?
3 Was the office in a convenient location?
4 Were the office hours convenient and generally accommodating to your schedule?
5 Upon arrival were you greeted courteously and in a timely manner?
6 Were you seen in a timely manner the day of your appointment?
7 Was the pre-examination testing and the examination thorough?
8 Did you feel the doctor was interested in your eye health and vision?
9 Did the doctor explain the results of your exam and fully answer your questions?
10 Did the optical dispensary have a good selection of frames?
11 Were the available optical products, options, and charges clearly explained?
12 Were you pleased with the quality of your eye wear/contact lenses?
13 Were you satisfied with how long it took to recieve your eyewear/contact lenses?
14 Was the office staff pleasant and courteous?
15 How would you rate your overall satisfaction with our office?

16

 Would you refer a friend or family member to our office for future eye care needs?
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