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Warwar Eye Group
Warwar Eye Group Visit Survey
Please take a moment to fill out our brief survey. All responses are anonymous.
1. Demographic Information
Age
Reason for Visit
Routine exam, specific medical issue or other)
Choose one
Routine exam
Specific medical issue
Other
Please rate the following
1 star being least and 5 stars being best
2. Appointment Scheduling
Ease of Scheduling
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Wait Time for Appointment
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Appointment Availability
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3. Quality of Care
Thoroughness of the Eye Exam
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Explanation of Findings
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Satisfaction with the Doctor’s Knowledge
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4. Overall Experience
Courtesy and Professionalism of Staff
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Likelihood to Recommend the Practice
0
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Overall Satisfaction of the Practice
Rank the following 1 star being least to 5 stars being best
0
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5
Additional Feedback
Suggestions for Improvement
Submit
Please do not fill in this field.
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