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Satisfaction Survey
jeremy
2025-05-09T04:36:37+00:00
Satisfaction Survey
Tell Us About Your Visit
Survey Form
Which Office Did You Visit?
*
Kent
Cuyahoga Falls
Which Doctor Did You See?
*
Dr. Hussing
Dr. Fath
Which Optician Did You Work With?
*
I don't remember!
George
Denise
Nancy
Andrea
Susan
Sandy
Other
Which Optician Did You Work With?
What Was the Nature of Your Visit?
*
Eye Exam and Glasses
Eye Exam and Contact Lenses
Pickup Glasses
Pickup Contacts
Medical Condition
Were you greeted promptly and courteously?
*
Yes
No
Did you have to wait long to see the Doctor?
*
Yes
No
Did the Doctor spend an appropriate amount of time with you?
*
Yes
No
Did the Doctor spend an appropriate amount of time with you?
*
Yes
No
Did the Doctor thoroughly explain the results of your exam?
*
Yes
No
Was the Front Desk Staff polite and helpful?
*
Yes
No
Was the Optician courteous and helpful?
*
Yes
No
Did the Optician explain all the options available to you?
*
Yes
No
Did the Optician answer your questions competently and completely?
*
Yes
No
Was the variety of eyewear satisfactory?
*
Yes
No
Did the staff thoroughly explain our fees and answer your insurance questions?
*
Yes
No
Were your eyeglasses ready in a reasonable amount of time?
*
Yes
No
Were your eyeglasses adjusted comfortably upon delivery?
*
Yes
No
When purchasing Contacts from us do you:
*
Pick them up at the Office.
Have them direct shipped from the manufacturer.
Your Name
*
Your Email
*
Additional Comments
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