Prescription Goggles Satisfaction Survey

Message

Instructions

Please answer the following questions about your satisfaction with the Super Specs/Play Hard. Don’t Blink Prescription Goggle program.

Parent First Name

Parent Last Name

How did you hear about the prescription goggle program?

Please rate the level of ease to complete the application for prescription goggles.

If you indicated “somewhat difficult” or “very difficult,” please explain:

How satisfied were you with the time between the submission of your application and the receipt of your child’s goggles?

If you indicated “somewhat dissatisfied or “very dissatisfied,” please explain:

How satisfied were you with the quality of the goggles you received for your child?

If you indicated “somewhat dissatisfied” or “very dissatisfied,” please explain:

How likely are you to recommend this program to another parent?

Prescription gogglessatisfaction survey