Bowie Optometric Group Patient Satisfaction Survey

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Survey

To better serve you in the future, please take a moment to tell us about your recent experience with the Bowie Optometric Group by filling out this survey.



What was the reason for your visit?
Were you a new or returning patient?	New Returning
How did you find out about us?
Do you have vision insurance?	Yes, name of insurance? No

STAFF

On a scale of 1 to 5, 1 being poor, and 5 being excellent, how would you rate the friendliness of the staff?	12345
On a scale of 1 to 5, 1 being poor, and 5 being excellent, how helpful was the staff?	12345
Were they able to answer your questions?	Yes No

DOCTOR

Were you happy with the doctor you saw?	Yes No
Did he/she answer your questions?	Yes No
Do you feel he/she did a thorough exam?	Yes No

ORDERS

How long did you have to wait for your order to arrive?
Was it correct or to your satisfaction?	Yes No
How were you informed your order was ready?
If service were available, would you prefer we email you when your order is ready?	Yes No
When you come back to pick up your order, how long did you have to wait?

FRAMES

On a scale of 1 to 5, 1 being poor, and 5 being excellent, how would you rate our selection?	12345
Are there any designers you would like us to carry?

CONTACT LENSES (Contact lens patients only)

If service were available, would it be more convenient to have your contact lens order shipped directly to your house?	Yes No



On a scale of 1 to 5, 1 being poor, and 5 being excellent, how would you rate your over-all satisfaction with the Bowie Optometric Group?	12345
Would you recommend us to friends and family?	Yes No Maybe
List any other suggestions/comments below:

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