Please complete our patient satisfaction survey. By doing so, you will be entered to win a $100 gift certificate to McCulley Optix Gallery! To enter, please complete the demographic information at the bottom of the survey. Your responses will remain confidential. You may also respond anonymously.   1. Was our staff courteous and helpful in the office? Yes No 2. Was our staff courteous and helpful on the phone? Yes No 3. Was your eye exam thorough? Yes No 4. Were you satisfied with the explanation of your visual conditions and treatment options? Yes No 5. Were you satisfied with the eyewear selection? Yes No 6. Would you refer a friend or family member to our office for eyecare or eyewear? Yes No 7. How would you rate your overall satisfaction with our office? Great Good Fair Poor 8. We welcome your suggestions or comments: Would you like a response to your comments? If so, please complete your information below.   Name:   Email:   Phone: ( ) - Thank you for completing the survey! Enter to win a $100 gift certificate by completing the information below.   First Name:   Last Name:   Address Line 1:   Address Line 2:   City:   State:   Zip Code: To prevent spamming, we require that you validate that you are a human. Please enter the answer to the question in the box below.   What is the sum of + ?