Our goal at Shady Grove Eye and Vision Care is to always offer service "above and beyond" what is expected. We are here to serve you. Your input is extremely valuable to us. If you have a comment about a specific employee, be it a compliment or a criticism, please tell the office manager or e-mail her at kim@youreyesite.com. Please take a moment to fill out this form.
Date of Examination:
Doctor who Examined you:
Please rate the service you received in the following areas of our practice by circling the option that applies.
Doctor’s Examination:
Poor
Average
Above Average
Excellent
Doctor’s Explanation of your Diagnosis and “Bedside Manner”
Poor
Average
Above Average
Excellent
Optical/Optician assistance including satisfaction with eyeglass lenses, frames, and timeliness of order and notification that glasses had arrived
Poor
Average
Above Average
Excellent
Comment:
Reception – Telephone etiquette of the receptionist when scheduling your appointment, how you were treated upon entering the office and upon leaving the office
Poor
Average
Above Average
Excellent
Comment:
Medical Billing Coordinator – Were all your questions regarding your insurance benefits answered to your satisfaction? Were you able to communicate effectively with the Medical Billing coordinator?
Poor
Average
Above Average
Excellent
Comment:
Timeliness of your appointment
Were we on time?
Yes
No
If new to the office, were you given good driving directions?
Yes
No
If a not new to the office, did you receive your recall notification?
Yes
No
Comment:
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