Feedback form Hamilton Eye Clinic is committed to providing an Ophthalmic service of excellence to the greater Waikato community. In order to achieve this we are continually assessing and reviewing our performance. As one of our patients, their caregiver or support person, you are the best gauge of our service excellence. Your feedback enables us to improve our level of service to you, so we would like your input. Please answer the following questions to indicate your level of satisfaction with our service.How satisfied were you with the Hamilton Eye Clinic reception?*Very UnhappyA Little UnhappySatisfiedHappyVery HappyHow satisfied were you with the pre-treatment tests?*Very UnhappyA Little UnhappySatisfiedHappyVery HappyHow satisfied were you with the consultation with your doctor?*Very UnhappyA Little UnhappySatisfiedHappyVery HappyHow satisfied were you with the staff friendliness in general?*Very UnhappyA Little UnhappySatisfiedHappyVery HappyHow satisfied were you with the helpfulness of staff?*Very UnhappyA Little UnhappySatisfiedHappyVery HappyHow satisfied were you with your privacy & dignity being maintained?*Very UnhappyA Little UnhappySatisfiedHappyVery HappyHow satisfied were you with cultural & individual values being respected?*Very UnhappyA Little UnhappySatisfiedHappyVery HappyHow satisfied were you with the condition of the facilities?*Very UnhappyA Little UnhappySatisfiedHappyVery HappyWhat is your overall satisfaction with the visit?*Very UnhappyA Little UnhappySatisfiedHappyVery HappySome quick questions about youPlease select: At this visit I was a* Patient Caregiver Support person Are you a new or existing patient?* New patient Existing patient Who were you referred by?* GP / Doctor Optometrist Self Referral / Friend Apart from GP or Optometrist referrals, did you hear about Hamilton Eye Clinic any other way? Yellow Pages Advertising (newspaper, etc) Web search A talk or presentation Other None. Only through GP or optometrist. What were the "Other" ways you heard about us? Have you visited our website before today?* Yes No Did you have any trouble finding Hamilton Eye Clinic when you visited? Yes No Can you please tell us what the issue was so that we can work towards improving our directions?*Is there anything else you would like us to know?Would you like our Practice Manager to contact you about anything in this survey? Yes No Please enter your contact details so that our Practice Manager can contact you.Your name* Email Day time phone number: Mobile number CommentsThis field is for validation purposes and should be left unchanged.
