Introduction

Eye Surgery Associates (ESA) is committed to continually improving the service and care we provide to our patients.


To help ESA achieve this goal we would like to ask you about your experience as a patient of ESA and how we can improve what we do.

If you would like the opportunity to discuss your feedback further with our senior management please ensure you enter your contact details in the space provided at the end of the survey.

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* 1. What ESA location do you mainly attend?

For the following eight questions please use the scale of zero to ten rate your level of satisfaction, with zero being completely dissatisfied and ten being completely satisfied.

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* 2. How would you rate the customer service you receive at ESA.

0 5 10
i We adjusted the number you entered based on the slider’s scale.

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* 3. How easy was it to get an appointment that was suitable to your needs?

0 5 10
i We adjusted the number you entered based on the slider’s scale.

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* 4. How well did the ESA staff listen to your questions and concerns?

0 5 10
i We adjusted the number you entered based on the slider’s scale.

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* 5. How well did ESA staff explain things to you?

0 5 10
i We adjusted the number you entered based on the slider’s scale.

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* 6. Did you feel that you spent a lot of time waiting?

0 5 10
i We adjusted the number you entered based on the slider’s scale.

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* 7. Did you feel the length of your appointment was adequate?

0 5 10
i We adjusted the number you entered based on the slider’s scale.

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* 8. Did you feel that the cost of your appointment was appropriate?

0 5 10
i We adjusted the number you entered based on the slider’s scale.

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* 9. If my family, friends or colleagues needed to see an ophthalmologist I would recommend ESA.

0 5 10
i We adjusted the number you entered based on the slider’s scale.

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* 10. Is there anything else you would like to tell us about how we could improve your experience at ESA?

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* 11. If you would you like to be contacted to discuss your survey responses further, please provide your details below.

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