Dear Valued Customer,
Thank you for patronizing us. It has been a pleasure serving you. Nevertheless, your valuable suggestions and comment to help us in assessing our service will be much appreciated. We are always striving to improve ourselves for your satisfaction.

Please fill in your name & e-mail address

	Mr. Ms.
First Name :	*
Last name :	*
E-mail :	*
Contact Number :

Please tick answer the following.

1. Why did you choose to patronize us? (Please choose 1 or more factors)

Family/Friends recommendations	Product Quality	Reputation
Our Location(convenient)	Customer Service	Advertisements
Others

2. Which outlet did you visit?

Plaza Singapura	Liang Court Shopping Centre	Tiong Bahru Plaza	Bugis Junction
Takashimaya Shopping Centre	Holland Road Shopping Centre	Harbour Front Centre	Junction 8 Shopping Centre
Suntec City Mall	Vivo City	Parkway Parade	Tampines 1
313 @ Somerset

Please rate our service.	<1 - Fantastic, 2 - Great, 3 - Average, 4 - Poor>
Approach   Please rate the reception you are received when you walked into the store.
3. Acknowledged you with a smile.	1     2     3     4
4. Greeting with a welcoming manner.	1     2     3     4
Appearance   Please rate the staff appearance.
5. Staff dressing presentation.	1     2     3     4
6. Personal grooming.	1     2     3     4
Ambience   Please rate the store ambience for environment.
7. Clean and tidy environment.	1     2     3     4
8. Merchandise displayed in a customer-friendly manner.	1     2     3     4
Attitude   Please rate the staff attitude.
9. Responsiveness of the service staff.	1     2     3     4
10. Made you feel welcomed and comfortable.	1     2     3     4
Assistance   Please rate how well you were assisted.
11. Listened carefully to your concerns and queries.	1     2     3     4
12. Offered appropriate advice to your concerns.	1     2     3     4
13. Reaffirm the features and benefits of the product.	1     2     3     4
Farewell
14. Thanked you at the end of your visit.	1     2     3     4
15. Advised on after care service.	1     2     3     4
16. Advised when your next eye test/health check is needed.	1     2     3     4
Advocacy
17. Will you return to store for your future optical needs?	Yes No
18. Will you recommend our store to others?	Yes No
19. Would you like to receive any information from us in future?	Yes No
20. Any other areas you would like us to improve on?