GoldenVision2020.com
Golden San Gabriel Optometric Vision Center
Golden Rowland Heights Optometry
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Lasik
Ortho-K

Survey

At Golden Vision, your satisfaction is very important to us. Please complete the survey below to help us provide the best service possible.

1. Convenience of our office hours.
Excellent
Good
Satisfactory
Less than Satisfactory
Poor
N/A (Not Applicable)
2. The treatment you received when you called to set up your appointment.
Excellent
Good
Satisfactory
Less than Satisfactory
Poor
N/A (Not Applicable)
3. The greeting you received when you arrived at the office for your appointment.
Excellent
Good
Satisfactory
Less than Satisfactory
Poor
N/A (Not Applicable)
4. Overall appearance of the office.
Excellent
Good
Satisfactory
Less than Satisfactory
Poor
N/A (Not Applicable)
5. Promptness with which you were seen by the doctor.
Excellent
Good
Satisfactory
Less than Satisfactory
Poor
N/A (Not Applicable)
6. The explanation and recommendations from your doctor concerning your eye health.
Excellent
Good
Satisfactory
Less than Satisfactory
Poor
N/A (Not Applicable)
7. Doctor's friendliness and courtesy.
Excellent
Good
Satisfactory
Less than Satisfactory
Poor
N/A (Not Applicable)
8. Staff's friendliness and courtesy.
Excellent
Good
Satisfactory
Less than Satisfactory
Poor
N/A (Not Applicable)
9. The choices available in frames and contacts.
Excellent
Good
Satisfactory
Less than Satisfactory
Poor
N/A (Not Applicable)
10. Your overall experience at Golden Vision.
Excellent
Good
Satisfactory
Less than Satisfactory
Poor
N/A (Not Applicable)
11. Would you recommend Golden Vision to a family member or friend?
Yes
No
Maybe
12. How did you hear about Golden Vision?
Family/friend
Website
Newspaper/magazine ad
Location
Radio ad
Golden Vision employee
Mailing
Other
13. Please provide additional comments and/or a testimonial about your experience at Golden Vision.
Store Location:
Name:
Address:
City:
State:
Zip Code:
Phone:
E-Mail Address:
I consent to the use of my name and this text for advertising and promotional purposes in connection to my experience with Golden Vision without additional compensation.