Start collecting valuable answers today.

Create this survey

Optical Health / Eye Care patient satisfaction survey


Please take a few minutes of your time to fill in the following survey.

Where did you first hear about our optical services?
Required answer

How did you book your professional eye appointment?
Required answer

Did you have any problems booking your appointment?
Required answer

How would you rate your examination overall?
Required answer

I strongly agree
I agree
I am unsure
I disagree
I strongly disagree
It was a nice experience
The examination was carried out quickly
The Optician or specialist operated professionaly
The Optician accommodated me and adapted to my needs
The Optician provided me with all the necessary information

Do you prefer to wear Contact Lenses or Spectacles?
Required answer

How would you rate your overall experience with us?
Required answer

Please rate the following points on a scale from 1 to 5, 1 - Excellent, 5 - Very poor

The facilities, equipment and comfort during your visit
Your experience with our Staff
Your experience in the examination room
The range of Spectacles and contact lenses we offer
The range of acessories available
How quickly your new eyeware was produced
How do you rate our pricing plan
Your experience with the optical consultant

Would you recommend us to a friend or collegue?
Required answer

Please confirm your gender:
Required answer

Please confirm your age:
Required answer

20 characters remaining

Please tell us how you would like us to improve:
Required answer

1500 characters remaining