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Eye Pac Survey 

Instructions

Your thoughts and concerns on the direction of Opticianry in Florida is important to us. We would greatly appreciate it if you would take just a few moments to share your opinions with us, so that we may better serve your needs. Please send this survey back to us at 1947 Greenwood Drive, Tallahassee, FL 32303 - along with your commitment form - as soon as possible. Your responses will be completely confidential unless you choose to identify yourself. 

Please print out the form and send to the POF office along with your commitment form.

Survey

Please rate the following issues:

1. Existing Florida opticianry laws and rules are adequate to prohibit unlicensed practice. The current laws and rules need to be more diligently enforced.
Strongly Agree  |  Agree  |  Neutral  |  Disagree  |  Strongly Disagree

2. Florida laws and rules should be strengthened to prohibit the unlicensed practice of opticianry.
Strongly Agree  |  Agree  |  Neutral  |  Disagree  |  Strongly Disagree

3. The Florida opticianry apprenticeship program should require mandatory classroom education hours.
Strongly Agree  |  Agree  |  Neutral  |  Disagree  |  Strongly Disagree

4. Opticians should be allowed access to all third-party payer programs.
Strongly Agree  |  Agree  |  Neutral  |  Disagree  |  Strongly Disagree

5. Opticians should be allowed to refract patients with the direct supervision of a doctor.
Strongly Agree  |  Agree  |  Neutral  |  Disagree  |  Strongly Disagree

6. Opticians should be allowed to refract patients without the direct supervision of a doctor.
Strongly Agree  |  Agree  |  Neutral  |  Disagree  |  Strongly Disagree

7. Opticians should be allowed to charge a dispensing fee in third-party payer programs.
Strongly Agree  |  Agree  |  Neutral  |  Disagree  |  Strongly Disagree

8. The Florida law that restricts optometrists from working for opticians or corporations should be abolished.
Strongly Agree  |  Agree  |  Neutral  |  Disagree  |  Strongly Disagree

9. Other. Please attach a separate sheet to express any other concerns about opticianry that are important to you.

Finally, please circle the number of the most important concern listed above.

1   2   3   4   5   6   7   8   9

Thank you. Please return this survey and your commitment form today! You may mail it to:

POF
1947 Greenwood Drive
Tallahassee, FL 32303

 

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