Eye Care One Satisfaction Survey
Thank you for selecting Eye Care One as your eye care provider. Please take a moment to tell us about your experience.
Based on your recent experience, would you recommend Eye Care One to your family and friends? Definitely Probably Might or Might Not Probably Not Definitely Not Other If you selected other please specify:
Please specify your satisfaction level with of our staff:
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
What specific things we can do to increase your satisfaction?
Please specify your satisfaction level with our doctor:
Seen in a timely manner
Courteous
Very knowledgable
Pleasant experience
Please select your main reason for choosing Eye Care One for your glasses purchase:
Yes
No
Selection
Price
Comfort
Namebrand
Insurance
Convenience
Same day service
Other
Based on your recent purchase experience, how satisfied are you with Eye Care One? Very satisfied Satisfied Neither satisfied nor dissatisfied Dissatisfied Very dissatisfied Other (please specify) If you selected other please specify:
Name of staff member who assisted you on your visit?
Please remember that this survey is confidential. Your name is not affiliated with this survey. Therefore, we value your honest opinion so that we can continue to improve to serve your needs.
Thank you for your time.
