Roberts Eyecare Associates Patient Survey

Please select the examination location. *
Please rate the following categories with 5 stars representing excellent and 1 star poor. *
Overall Satisfaction
Thorough Eye Health Examination
Sufficient Time with the Doctor
Treated in a Professional Manner
Office Staff Friendly and Knowledgeable
Office Appearance
Office Location
Office Hours
Obtained Timely Appointment
Waiting Time at Office
Frame and Lens Selection
Opticians (Adjust GLasses and Staff in Frame Room)
Would Recommend Practice to Friends and Relatives *
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The following information is optional.
Thank you for taking time to fill out this survey. Your responses will help us to provide you with better eye care.

When completed, please click on the SUBMIT button.

Dr. Roberts
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