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Surveys
2017
June
L
LASIK Patient Satisfaction Survey 1 wk
LASIK Patient Satisfaction Survey 1 wk
0%
Questions marked with a
*
are required
Exit Survey
*
Are you male or female?
Male
Female
*
Which vision correction procedure did you have?
WaveLight LASIK
CONTOURA® Vision LASIK
PRK
Visian ICL
Clear Lens Exchange (Symfony IOL)
PRK with cross-linking
How satisfied are you with the following experiences:
Very Dissatisfied
Not Satisfied
Neutral
Satisfied
Very Satisfied
*
Obtaining information prior to your exam
*
Scheduling your LASIK consultation
*
Scheduling your LASIK surgery
*
Waiting room lobby
Is there anything we could have done to improve your experience?
How satisfied are you with the following:
Very Dissatisfied
Not Satisfied
Neutral
Satisfied
Very Satisfied
*
Friendliness of the consultation/exam staff
*
The consultation/exam staff's ability to answer your questions
*
Friendliness of the surgery staff
*
The surgery staff's ability to answer your questions
Is there anything we could have done to improve your experience?
How satisfied are you with the following:
Not satisfied at all
1
2
3
4
5
6
7
8
9
Extremely satisfied
Overall experience
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