Evaluate Us

Name

Phone

Was our staff courteous and helpful?

Yes
No

If our staff was not courteous and helpful, please elaborate.

Were you seen in a timely manner?

Yes
No

If you were not seen in a timely manner, please elaborate.

Was your examination thorough?

Yes
No

If your examination was not thorough, please elaborate.

Our Doctors: Were you satisfied with your visual condition & treatment options explanations?

Yes
No

Our Doctors: If you were not satisfied with your visual condition & treatment options explanations, please elaborate.

Our Opticians: Were you satisfied with your visual condition & treatment options explanations?

Yes
No

Our Opticians: If you were not satisfied with your visual condition & treatment options explanations, please elaborate.

Did our contact lens/eyeglasses service & quality meet your expectations?

Yes
No

If our contact lens/eyeglasses service & quality did not meet your expectations, please elaborate.

Will you refer others to our office for their eye care?

Yes
No

If you will not refer others to our office for their eye care, please elaborate.

Please rate your overall satisfaction with our office. (1= very dissatisfied, 5= exceeded expectations)

1
2
3
4
5

May we contact you if your rating was 3 or below?

Yes
No

Other Information - You may elaborate on any information below, and/or in the office

Home Our Services Our Doctors Promotions Order Contacts Mailing List Patient Forms Employee Logins

Monday, Wednesday, Friday
9:00 am - 6:00 pm

Tuesday and Thursday
9:00 am - 5:00 pm

Saturday
9:00 am - 1:00 pm

5237 Jones Creek Road
Baton Rouge, Louisiana 70817

P: 225-755-3937
F: 225-755-2272