Patient Feedback
We would love to hear your thoughts or feedback on how we can improve your experience!
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Todays Date: *
MM
/
DD
/
YYYY
Which Vision XRAY Site did you visit recently? *
What services did you have today? Please select all that apply. *
Required
How did you find out about our practice? *
Required
How would you rate the practice on the following aspects? *
Excellent
Good
Poor
Convenience of appointment time
Easy to find
Appearance
Cleanliness
Wait time
How would you rate the staff on the following aspects? *
Excellent
Good
Poor
Professional
Understood my needs
Friendly
Efficient
Kept me informed as to what was happening. i.e. wait times, delays
We like to commend our staff for doing a great job. Was there a particular staff member that you would like to tell us about? Please tell us who that was and what they did well.
Is there anything we could have done to improve your last visit?
Thank you for taking the time to help us improve our services. If you would like a manager to contact you to discuss your feedback further, please write a brief description of your visit and your contact details. A  manager from Vision XRAY will contact you within 7-10 business days.
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