SurveyMonkey Powered Online Survey

Spivack Vision Center

Thank you for your participation in our Patient Survey. We appreciate your response to each of the questions below.

1. What was the ease of making your appointment?

	1(poor)	2	3	4	5(excellent)
.	What was the ease of making your appointment? . 1(poor)	. 2	. 3	. 4	. 5(excellent)

2. Were you checked into the office in a courteous and timely manner?

	1(poor)	2	3	4	5(excellent)
.	Were you checked into the office in a courteous and timely manner? . 1(poor)	. 2	. 3	. 4	. 5(excellent)

3. How long did you have to wait before being seeing by a technician?

	Less than 15 minutes	15 to 30 minutes	31 to 60 minutes	Over 60 minutes
.	How long did you have to wait before being seeing by a technician? . Less than 15 minutes	. 15 to 30 minutes	. 31 to 60 minutes	. Over 60 minutes

4. How long did you have to wait after seeing a technician before you were seen by a doctor?

	Less than 15 minutes	15 to 30 minutes	31 to 60 minutes	Over 60 minutes
.	How long did you have to wait after seeing a technician before you were seen by a doctor? . Less than 15 minutes	. 15 to 30 minutes	. 31 to 60 minutes	. Over 60 minutes

5. Was the check out process smooth?

	1(poor)	2	3	4	5(excellent)
.	Was the check out process smooth? . 1(poor)	. 2	. 3	. 4	. 5(excellent)

6. Was the technician professional?

	1(poor)	2	3	4	5(excellent)
.	Was the technician professional? . 1(poor)	. 2	. 3	. 4	. 5(excellent)

7. Did the doctor answer all your questions?

	1(poor)	2	3	4	5(excellent)
.	Did the doctor answer all your questions? . 1(poor)	. 2	. 3	. 4	. 5(excellent)

8. Would you refer your friends and/or family members to Spivack Vision Center / Colorado Laser Surgeons?

Would you refer your friends and/or family members to Spivack Vision Center / Colorado Laser Surgeons? Yes

9. If you wish to comment, please feel free to name doctors or staff in your comments.

If you wish to comment, please feel free to name doctors or staff in your comments.

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