Please complete this survey.

We appreciate your feedback and value your opinion!

1.Which office location did you visit? Buffalo Grove Libertyville
2. Was our staff courteous and helpful? Yes No
3. Were you seen in a timely manner? Yes No
4. Was your examination thorough? Yes No
5. Were you satisfied with the explanation of your visual conditions and treatment options? Yes No
6. If fit with contact lenses or glasses, did the service
and quality meet your expectations?		 Yes No
7. Would you refer a friend to our office for eye care? Yes No
8. How would you rate your overall satisfaction with our office?
(5 is highest)		 5 4 3 2 1

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