Skip to main content

Baraboo & Wisconsin Dells
Eye Clinic

Offering Premium Eye Care Services to the
Baraboo Range and Wisconsin Dells Region

Baraboo (608) 356-6276

Wisconsin Dells (608) 253-4593

Our Practice
Locate Us
Contact Us
Patient Forms
Eye Library

Our Practice
Locate Us
Contact Us
Patient Forms
Eye Library

Our Practice
Locate Us
Contact Us
Patient Forms
Eye Library

Our Practice
Locate Us
Contact Us
Patient Forms
Eye Library

Menu

Wisconsin Dells Eye Clinic

Baraboo Eye Clinic

Young-Woman-Smiling-1280x480

Mom-Son-Grassy-Field-1280x480

Hugging-Wearing-Sunglasses

Mom-Son-Blowing-Bubbles-1280x480

Home » Contact Us » Satisfaction/Feedback Survey

Satisfaction/Feedback Survey

Please take a few moments and let us know what you thought of your last visit…

Please let us know how your last visit went.
Location
Service Ratings
Communication prior to appointment
- Great
- Good
- Fair
- Poor
- N/A
Appointment availability
- Great
- Good
- Fair
- Poor
- N/A
Waiting room time
- Great
- Good
- Fair
- Poor
- N/A
Fees
- Great
- Good
- Fair
- Poor
- N/A
Quality of care from staff
- Great
- Good
- Fair
- Poor
- N/A
Quality of care from doctor
- Great
- Good
- Fair
- Poor
- N/A
Concerns or questions answered
- Great
- Good
- Fair
- Poor
- N/A
Overall quality of care
- Great
- Good
- Fair
- Poor
- N/A
Scheduling
Preferred day for appointments
Preferred time for appointments
Do you plan on returning for your next comprehensive examination?
- Yes
- No
Please tell us why not
Would you schedule appointments online?
- Yes
- No
Please tell us why not
Products
Satisfaction with eyeglasses
- Great
- Good
- Fair
- Poor
- N/A
Satisfaction with contact lenses
- Great
- Good
- Fair
- Poor
- N/A
Range of eyeglasses selection
Identification - This section is optional.
Why did you choose us for your eye health care?
Your Name (Optional)
First Last
Additional comments
Email
This field is for validation purposes and should be left unchanged.

Search:

Hours & Locations

Review Us On Google

Customer Satisfaction Survey

Pay Your Bill Online

Baraboo Eye Clinic

920 State Rd 136
Baraboo, WI 53913

Phone: (608) 356-6276
Fax: (866) 318-0547

In case of emergency, please phone our office at the number listed above and follow the instructions.

Wisconsin Dells Eye Clinic

130 Commerce St
Wisconsin Dells, WI 53965

Phone: (608) 253-4593
Fax: (866) 318-0547

In case of emergency, please phone our office at the number listed above and follow the instructions.

Speak Field

Our Practice
Locate Us
Contact Us
Patient Forms
Eye Library

Our Practice
Locate Us
Contact Us
Patient Forms
Eye Library

Home
Contact Us
Privacy Policy
Disclaimer

Home
Contact Us
Privacy Policy
Disclaimer

Baraboo Eye Clinic - Located at 920 State Rd 136, Baraboo, WI 53913 Phone: (608) 356-6276 www.baraboodellseyeclinic.com

Wisconsin Dells Eye Clinic - Located at 130 Commerce Street, Wisconsin Dells, WI 53965 Phone: (608) 253-4593 www.baraboodellseyeclinic.com

Powered by EyeCarePro.com
The materials and articles contained on this website are copyrighted and protected under Title 17 of the United States Code
Email Accessibility | Website Accessibility Policy | Login