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* 1. How long have you been considering LASIK?

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* 2. Have you had, or are planning on having, a LASIK consultation elsewhere:

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* 3. How would you rate your experience with the doctor? (thoroughness, recommendations, questions answered, enough time spent, reassuring, helpful, etc)

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* 4. How would you rate your experience with the patient counselor? (helpful, informative, comforting, thorough, knowledgeable, questions answered, etc)

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* 5. How would you rate your overall experience with our practice? (wait time, friendliness of staff, education materials, appearance of office, atmosphere, etc)

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* 6. What were your main reasons for not scheduling your LASIK procedure with Heaton Eye Associates?

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* 7. Please let us know what we could have done to improve your experience or to help in your decision to have LASIK with Heaton Eye Associates?

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