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Optical Health / Eye Care Patient Satisfaction Survey
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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1
How satisfied are you with the overall service you received?
Please rate your satisfaction with the service provided.
2
Did the staff treat you with respect and courtesy?
Please select one option that best describes your experience.
Yes, always
Most of the time
Rarely
3
How likely are you to recommend our services to others?
Please provide your feedback on the likelihood of recommending our services.
4
Did you experience any delays during your appointment?
Please share if you faced any delays during your appointment.
No delays
Minor delays
Significant delays
5
Are you satisfied with the cleanliness of the facility?
Please indicate your level of satisfaction with the cleanliness.
Very satisfied
Somewhat satisfied
Not satisfied
6
Please describe your experience with the optometrist.
Share your detailed feedback on the optometrist's service.
7
Were your concerns and questions addressed satisfactorily?
Please provide your feedback on the resolution of your concerns.
Yes, completely
Partially
No
8
How well did the optometrist explain your eye health condition?
Rate the optometrist's explanation of your eye health condition.
9
Would you visit our clinic again for your optical health needs?
Please indicate your likelihood of revisiting our clinic.
Definitely
Maybe
Not at all
10
Additional Comments
Please provide any additional feedback or comments that you would like to share.
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