Department of Ophthalmology & Visual Sciences Satisfaction Survey

We make an effort to provide the highest level of care to our patients. TO do this, we need your feedback. Please rate The University of Iowa Department of Ophthalmology & Visual Sciences.

Please indicate by marking the box of the service(s) in which you were seen during this visit.

Comprehensive Ophthalmology & Cataract
Contact Lens
Cornea / External Disease
Glaucoma
Laser Refractive Surgery
Low Vision
Neuro-Ophthalmology
Oculoplastics
Optometry
Pediatric Ophthalmology / Adult Strabismus
Retina / Vitreous
Uveitis
Vascular Disease

Were you seen as

New Patient Return Patient

Date of Appointment

Format: YYYY-MM-DD

Visit Satisfaction

Yes No
Were you satisfied with your care?
Were your health care questions answered to your satisfaction?
Would you recommend us to your family or friends?

Based on your most recent visit, how satisfied are you with Department of Ophthalmology & Visual Sciences?

Very satisfied Satisfied Neutral Dissatisfied Very dissatisfied