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Focus Aesthetics
Fernandina Beach
Gate Parkway/295
Mandarin
Neptune Beach
Nocatee
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Orange Park
Ormond Beach
Palm Coast
Ponte Vedra Beach
Riverside
San Marco
Southpoint
St. Augustine
Fountains at St. Johns (Now Open!)
Home
About
About Us
Patient Testimonials
In the News
Join Our Team
Florida Eye Select
Our History
Specialties
Cataracts
Glaucoma
Dry Eye
LASIK
Cornea
Retina
Oculoplastics
Cosmetic Surgery & Spa
Research & Clinical Trials
Cataracts
Meet Our Team
Patient Resources
At-Home Eye Tests
Video Library
Articles & Blogs
Insurance Information
Financing Options
Patient Forms
Patient Portal
HIPAA & Privacy Policy
Good Faith Estimate
FAQs
Cataract FAQs
Dry Eye FAQs
LASIK FAQs
Oculoplastics FAQs
Locations
Focus Aesthetics
Fernandina Beach
Gate Parkway/295
Mandarin
Neptune Beach
Nocatee
Northside
Orange Park
Ormond Beach
Palm Coast
Ponte Vedra Beach
Riverside
San Marco
Southpoint
St. Augustine
Fountains at St. Johns (Now Open!)
Request Appointment
Excellence in Eye Care
Referring Provider Partnership Survey
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Referring Provider Partnership Survey
1. How satisfied are you with your overall experience referring patients to Florida Eye Specialists?
(Required)
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
2. How likely are you to refer patients to Florida Eye Specialists in the future?
(Required)
Extremely Likely
Likely
Neutral
Unlikely
Very Unlikely
3. Approximately how often does your practice refer patients to Florida Eye Specialists?
(Required)
Weekly
Monthly
Occasionally
Rarely
Never
4. How would you rate the timeliness of appointment availability for referred patients?
(Required)
Excellent
Good
Fair
Poor
5. For urgent patient referrals, how responsive has Florida Eye Specialists been?
(Required)
Excellent
Good
Fair
Poor
Not Applicable
6. How would you rate the experience your staff has when scheduling patients with our offices?
(Required)
Excellent
Good
Fair
Poor
7. How satisfied are you with the timeliness and clarity of consult reports returned to your office?
(Required)
Excellent
Good
Fair
Poor
8. How satisfied are you with communication between our physicians and your practice when needed?
(Required)
Excellent
Good
Fair
Poor
9. Based on feedback from your patients, how would you rate their experience at Florida Eye Specialists?
(Required)
Excellent
Good
Fair
Poor
10. Which other ophthalmology practices do you currently refer patients to?
(Required)
11. What are the most important factors when choosing where to refer a patient?
Appointment Availability
Physician Expertise
Communication with Referring Doctor
Patient Experience
Location Convenience
Technology or Specialty Services
Insurance Acceptance
12. What is one thing Florida Eye Specialists could improve that would make you more likely to refer patients to our practice?
(Required)
13. Which services do you currently refer to Florida Eye Specialists?
Cataract Surgery
Retina
Glaucoma
Cornea
Oculoplastics
LASIK
Comprehensive Ophthalmology
Your Name (optional)
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