Eyes On J

VSP members click here to view your detailed benefit information.

At Eyes on J Optometry we strive to meet and exceed your expectations in all aspects of your vision care. Your feedback is very important in helping us to maintain the highest level of care. We appreciate your time to take this quick anonymous survey.

Please rate your experiences on the scale from Excellent to Poor.


5 - Excellent   4 - Good   3 - Fair   2 - Poor   1 - Not Applicable

1. Please rate your overall experience at Eyes on J Optometry.

5 4 3 2 1

2. Please rate the quality of customer service provided by the front office staff.

5 4 3 2 1

3. Please rate your experience frame and lens selecting with the Optician.

5 4 3 2 1

4. Please rate how well the doctor addressed your vision and eye health needs.

5 4 3 2 1

5. Please rate the choice of frame styles available to you.

5 4 3 2 1

How many years have you been a patient with our practice?

1st Visit 1-3 Years 3-6 Years 7-10 years More than 11

What is your age?

Under 18 18-29 30-39 40-49 50-59 60-69 70+

Are you male or female?

Male   Female

Would you refer your family and friends to Eyes on J Optometry?

Yes     No

Please add any additional comments you feel will help us understand your experience:







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