* indicates that an answer is required
1.
Practice information
*Practice name
Account Number
Zip Code
*Lab Name
Sales Consultant
2.
Please rank our lab from 1 to 10 with 1 being very dissatisfied and 10 being very satisfied
12345678910
*Overall Satisfaction
*Optical Quality (correct prescription, order specs)
*Cosmetic Quality
*Customer Service (knowledgeable, friendly)
*Lab Communication (notice of late jobs, alternative solutions offered)
*Acctg/Billing (accuracy, ease of payment, credit processing)
*Interaction with Sales Consultants
*Turnaround Time
3.
What would make us exceptional in the following categories?
Overall Satisfaction
Optical Quality
Cosmetic Quality
Customer Service
Lab Communication
Acctg/Billing
Sales
Turn-time
4.
How likely is it that you would recommend us to a colleague or friend?
1 being least likely to 10 being highly likely
12345678910
*How likely is it you would recommend us?
5.
What is the primary reason for your answer to question #4?
6.
Based on your experience with our lab, are you more likely to?
7.
We appreciate your feedback.  Please provide any additional comments/suggestions.
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