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The University Eye Center Referral Service would like to take this opportunity to thank you for you referrals and continued support.

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Referral Service Satisfaction Questionnaire

In order to continue to meet your needs and maintain the level of quality that we provide, we ask that you take a few minutes to complete the following survey.

Name:

Did you encounter any problems making your referral?

Yes     No

If so, please explain:


Are you satisfied with our services at UEC?

Yes     No

If not, how can we improve our services?