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Subject

1. How likely are you to refer a friend to us? (1 never, 5 very likely)
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2. How would you rate your overall experience? (1 poor, 5 great)
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3. How friendly was the doctor? (1 not at all, 5 very)
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4. Did the doctor explain everything to you and answer all your questions? (1 not at all, 5 very)
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5. How friendly and helpful was the staff? (1 not at all, 5 very)
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6. How knowledgeable was the staff? (1 not at all, 5 very)
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7. How would you rate the glasses selection? (1 terrible, 5 good)
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8. How can we improve our optical staff and selection? (certain brands, etc.)

9. What could have we done better?

10. Please provide any additional comments.

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