How did we do?

<% function FieldOK(FieldName) if Request.Form(FieldName) = "" and Request.Form("send") then FieldOK = false else FieldOK = true end if end function function FieldWithDefaultOK(DefaultValue, FieldName) if Request.Form(FieldName) = DefaultValue and Request.Form("send") then FieldWithDefaultOK = false else FieldWithDefaultOK = true end if end function %> <%if Request.Form("send") <> "" then if Request.Form("Prenom") = "" or FieldWithDefaultOk("Jour", "Day") = false or FieldWithDefaultOk("Mois", "Month") = false or FieldWithDefaultOk("Year", "Year") = false or Request.Form("CodeRegional") = "" or Request.Form("Tel1") = "" or Request.Form("Tel2") = "" or Request.Form("Courriel") = "" then Response.Write("Please fill all mandatory fields *") end if end if if Request.Form("Prenom") <> "" and FieldWithDefaultOk("Jour", "Day") and FieldWithDefaultOk("Mois", "Month") and FieldWithDefaultOk("Year", "Year") and Request.Form("CodeRegional") <> "" and Request.Form("Tel1") <> "" and Request.Form("Tel2") <> "" and Request.Form("Courriel") <> "" then Set Mailer = Server.CreateObject("CDONTS.NewMail") ' Variable ajoutée par Max Dim bodyMail ' Construire le contenu du mail bodyMail = bodyMail & "IDENTIFICATION " & vbCrLf & vbCrLf bodyMail = bodyMail & "Name: " & Request.Form("Titre") & " " & Request.Form("Prenom") & vbCrLf & vbCrLf bodyMail = bodyMail & "Telephone: " & Request.Form("CodeRegional") & "-" & Request.Form("Tel1") & "-" & Request.Form("Tel2") & vbCrLf & vbCrLf bodyMail = bodyMail & "Email: " & Request.Form("Courriel") & vbCrLf & vbCrLf bodyMail = bodyMail & "Appointment date: " & Request.Form("Day") & " " & Request.Form("Month") & " " & Request.Form("Year") & vbCrLf & vbCrLf bodyMail = bodyMail & "Optometrist: " & Request.Form("Optometriste") & vbCrLf & vbCrLf& vbCrLf & vbCrLf bodyMail = bodyMail & "OUR CARE " & vbCrLf & vbCrLf bodyMail = bodyMail & "How would you rate your eye exam? " & Request.Form("examen") & vbCrLf & vbCrLf bodyMail = bodyMail & "Your optometrist took the time to explain all the stages of your eye exam... " & Request.Form("explications") & vbCrLf & vbCrLf bodyMail = bodyMail & "In your opinion, would you say that the eye exam you received was thorough and complete? " & Request.Form("complet") & vbCrLf & vbCrLf& vbCrLf & vbCrLf bodyMail = bodyMail & "OUR SERVICES " & vbCrLf & vbCrLf bodyMail = bodyMail & "The communications with our office to arrange your appointment were: " & Request.Form("communication") & vbCrLf & vbCrLf bodyMail = bodyMail & "Would you say that our clinic is easily accessible? " & Request.Form("acces") & vbCrLf & vbCrLf bodyMail = bodyMail & "Your greeting at reception was: " & Request.Form("accueil") & vbCrLf & vbCrLf bodyMail = bodyMail & "During your visit, did we meet all your needs? " & Request.Form("besoins") & vbCrLf & vbCrLf bodyMail = bodyMail & "Do you have any suggestions on how we could improve? " & Request.Form("suggestions") & vbCrLf & vbCrLf bodyMail = bodyMail & "Improvements suggestions: " & Request.Form("suggestionamelioration") & vbCrLf & vbCrLf & vbCrLf & vbCrLf bodyMail = bodyMail & "OUR PRODUCTS" & vbCrLf & vbCrLf bodyMail = bodyMail & "Would you say that our selection of eye glass frames is: " & Request.Form("choixmontures") & vbCrLf & vbCrLf bodyMail = bodyMail & "Would you say that our selection of sunglasses is: " & Request.Form("choixsolaires") & vbCrLf & vbCrLf bodyMail = bodyMail & "Did we find the perfect frame for you? " & Request.Form("montureideale") & vbCrLf & vbCrLf bodyMail = bodyMail & "Did our clinic staff answer all of your questions and offer appropriate solutions regarding our products offered? " & Request.Form("choixdeproduits") & vbCrLf & vbCrLf bodyMail = bodyMail & "Are there any brands of frames or sunglasses that we didn’t have in stock that you would recommend we carry? " & Request.Form("montures") & vbCrLf & vbCrLf bodyMail = bodyMail & "Frames suggestions: " & Request.Form("monturessuggestion") & vbCrLf & vbCrLf bodyMail = bodyMail & "If you did not purchase frames during your visit, please specify the main reason: " & Request.Form("raisonachat") & vbCrLf & vbCrLf bodyMail = bodyMail & "Other reason: " & Request.Form("raisonachatautre") & vbCrLf & vbCrLf & vbCrLf & vbCrLf bodyMail = bodyMail & "RELATIONSHIP WITH YOU " & vbCrLf & vbCrL bodyMail = bodyMail & "How did you hear about our clinic? " & Request.Form("hear") & vbCrLf & vbCrLf bodyMail = bodyMail & "Referal: " & Request.Form("hearautre") & vbCrLf& vbCrLf bodyMail = bodyMail & "Would you recommend our clinic to your family and/or friend?  " & Request.Form("recommend") & vbCrLf & vbCrLf bodyMail = bodyMail & "I would not recommend for the wollowing reasons: " & Request.Form("recommendno") & vbCrLf& vbCrLf bodyMail = bodyMail & "Would you be interested in being kept informed of clinic promotions, offers or updates by email? " & Request.Form("contactme") & vbCrLf & vbCrLf bodyMail = bodyMail & "Comments: " & Request.Form("remarques") & vbCrLf & vbCrLf Mailer.Body = bodyMail ' Envoyer le mail Mailer.From = Request.Form("Courriel") Mailer.To = "dr.robock@cogeco.net" Mailer.Cc = Request.Form("Courriel") Mailer.Subject = "Survey - Family Optometry Dr E.L Robock" Mailer.Send %>

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Our aim is to offer you the highest quality service and care and to be your optometry clinic of choice for all your future eyecare needs.

We thank you for taking the time to fill out the following questionnaire. Your answers will give us a good indicator of what you think about our standard of care, services, products and our relationship with you.

All the fields followed by a * are mandatory.

Identification

Title: 
Full name*:  " /> <% if FieldOk("Prenom") = false then Response.Write("Enter your name") end if %>
Daytime telephone*:  " /> " /> " /> <% if FieldOk("CodeRegional") = false or FieldOk("Tel1") = false or FieldOk("Tel2") = false then Response.Write("Telephone no. mandatory") end if %>
Email*:  " /> <% if FieldOk("Courriel") = false then Response.Write("E-mail mandatory") end if %>
(For confirmation only. We will not share your email address with third parties)
Date of your appointment*: 
Name of your optometrist:
 " />

Our Care

How would you rate your eye exam?
Your optometrist took the time to explain all the stages of your eye exam...
In your opinion, would you say that the eye exam you received was thorough and complete?

Our Services

The communications with our office to arrange your appointment were:
Would you say that our clinic is easily accessible?
Your greeting at reception was:
During your visit, did we meet all your needs?

Do you have any suggestions on how we could improve?
Yes />    No />

If you answered "yes", please explain:

Our Products

Would you say that our selection of eye glass frames is:
Would you say that our selection of sunglasses is:

Did we find the perfect frame for you?

Did our clinic staff answer all of your questions and offer appropriate solutions regarding our products offered (frames, sunglasses, contact lenses, sports and leisure glasses)

Are there any brands of frames or sunglasses that we didn’t have in stock that you would recommend we carry?
Yes />    No />

If "Yes", please specify:
If you did not purchase frames during your visit, please specify the main reason:

Other, please explain:

Relationship with you

How did you hear about our clinic?

Referral or other, please specify:

Would you recommend our clinic to your family and/or friend?
Yes />    No />

If you answered “no”, what would be your main reason(s) for hesitating to refer us?
Would you be interested in being kept informed of clinic promotions, offers or updates by email?
Yes />    No />

Other comments:
    

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