Patient Satisfaction Survey

It is our goal at North Cascade Eye Associates to continuously improve our practice.  It’s patients like you who make the difference, and we’d like to know about your experience with us.  Please take a moment to let us know how we are doing!  Click the Submit button at the bottom of the page when you have completed this page. Thank You!

Appt Date:

We want you to feel important, valued and welcome.
How well did the receptionists convey that message?

Please score on a scale of 1-4.
(1 meaning not at all, 4 meaning very well): 1 2 3 4
Receptionist name:

 

We want you to be confident that your concerns have been heard and carefully documented, that you were treated carefully and respectfully.
How well did the technician meet this expectation?

Please score on a scale of 1-4.
(1 meaning not at all, 4 meaning very well): 1 2 3 4
Technician name:

 

We believe you deserve to have access to all of the visual and cosmetic advantages that modern optical technology can provide.
How well did the opticians present these options?

Please score on a scale of 1-4.
(1 meaning not at all, 4 meaning very well): 1 2 3 4
Optician name:

 

We want you to feel validated and reassured, to see your physician as your advocate and partner in achieving the best eye health possible.
How well did the physician achieve this goal?

Please score on a scale of 1-4.
(1 meaning not at all, 4 meaning very well): 1 2 3 4
Physician name: Dr. Crowell Dr. Siapco Dr. Heidar Dr. VanNurden Dr. Thornberg Dr. Heffernan Dr. Epley

 

Will you come back? (required) Yes     No     Maybe
Will you refer a friend?  (required) Yes     No     Maybe

 

If we provided you with a remarkable experience, if one or more of our staff left an impression on you; would you be so kind as to share the details with us?
Comments: