Customer Satisfaction Survey

Optima Eyecare values your feedback to improve care and ensure lasting patient satisfaction.

At Optima Eyecare, we take our customer satisfaction very seriously. We strive to offer our patients the best care possible. To do that, we ask our patients to complete the customer satisfaction survey below, so that we can continually improve and deliver the eye care you deserve. Your honest answers to these questions will help shape our practice. We thank you for your time in completing this survey and we look forward to caring for your vision needs for years to come.
  • First Name*
    0
  • Last Name*
    1
  • Email*
    2
  • Communication Prior To Your Appointment*
    Great
    Good
    Fair
    Poor
    N/A
    3
  • Appointment Availability*
    Great
    Good
    Fair
    Poor
    N/A
    4
  • Waiting Room Time*
    Great
    Good
    Fair
    Poor
    N/A
    5
  • Quality Of Care From Our Staff*
    Option A
    Option B
    Option C
    Option D
    Option E
    6
  • Quality Of Care From Our Doctors*
    Option A
    Option B
    Option C
    Option D
    Option E
    7
  • Fees*select just one
    Option A
    Option B
    Option C
    Option D
    Option E
    8
  • Concerns/Questions Answered*
    Option A
    Option B
    Option C
    Option D
    Option E
    9
  • Overall Quality Of Care*
    Option A
    Option B
    Option C
    Option D
    Option E
    10
  • Satisfaction With Your Eyeglasses*
    Option A
    Option B
    Option C
    Option D
    Option E
    11
  • Satisfaction With Your Contact Lenses*
    Option A
    Option B
    Option C
    Option D
    Option E
    12
  • Range Of Eyeglass Selection*
    Option A
    Option B
    Option C
    Option D
    Option E
    13
  • Why did you choose us for your eye care needs?*
    14
  • Why did you choose us for your eye care needs?*
    15
  • 16

Contact Info

Optima Eye

6365 Halcyon Way
Suite 935
Alpharetta, GA 30005

  404.662.4123
  470.253.0774
  info@optima-eye.com

Sign Up!