The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit North American phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

iMApcXqSKLogxj6DNSJGHIfq8tqRPTZnSvn7xw8vWYx

Patient Experience Survey

UNIVERSITY OF WATERLOO

School of Optometry and Vision Science

OPTOMETRY CLINIC PATIENT EXPERIENCE SURVEY

You are being invited to take part in this survey because you have recently had a visit at the Optometry Clinic. Your responses to the questions on this survey will help us improve the care we provide. There are seven sections of the survey and it will take approximately 10 minutes to complete.

Participation in the survey is voluntary and all your responses to the survey questions will be kept confidential.

Information and privacy: questions regarding the collection of information on this form can be directed to opt-surv@uwaterloo.ca

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.