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  1. Surveys
  2. 2017
  3. June
  4. L
  5. LASIK Patient Satisfaction Survey 1 wk
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Questions marked with a * are required Exit Survey
 
 
* Are you male or female?
 
Male
 
Female
 
 
 
* Which vision correction procedure did you have?
 
WaveLight LASIK
 
CONTOURA® Vision LASIK
 
PRK
 
Visian ICL
 
Clear Lens Exchange (Symfony IOL)
 
PRK with cross-linking
 
 
How satisfied are you with the following experiences:
Very Dissatisfied
Not Satisfied
Neutral Satisfied Very Satisfied
* Obtaining information prior to your exam
* Scheduling your LASIK consultation
* Scheduling your LASIK surgery
* Waiting room lobby
 
 
 
Is there anything we could have done to improve your experience?
   
 
 
How satisfied are you with the following:
Very Dissatisfied
Not Satisfied
Neutral
Satisfied Very Satisfied
* Friendliness of the consultation/exam staff
* The consultation/exam staff's ability to answer your questions
* Friendliness of the surgery staff
* The surgery staff's ability to answer your questions
 
 
 
Is there anything we could have done to improve your experience?
   
 
 
How satisfied are you with the following:
Not satisfied at all
1 2 3 4 5 6 7 8 9 Extremely satisfied
Overall experience