We would be grateful for a few minutes of your time with this brief questionnaire in relation to your recent visit to our practice. At Elcott Opticians we take customer care seriously and thank you for your custom and participation.
Was this your first visit, or are you an existing patient?
First visitExisting patient
How easy was it to make an appointment?
Very easySomewhat easyDifficultVery Difficult
How courteous were the staff at the reception desk?
Very courteousCourteousNot so courteousRude
How competent was the Optometrist who examined your eyes?
Did you feel that the Optometrist spent adequate time with you?
Did you feel that your eye examination was thorough?
How satisfied do you feel about any products purchased?
Not applicableExtremely satisfiedVery satisfiedSatisfiedNot satisfied
If you didn’t purchase any products at your last visit, how likely are you to purchase a product in the next 12 months?
Would you recommend Elcott Opticians to your family and friends?
Any other comments?
Please let us know if any comments above can be shared with existing or potential new patients?
Personal Information - this section is optional
Your Name (optional)
Your Email (optional)