Patient Survey We would like your name and email address, so we can respond to your survey, but it isn’t required. Patient Name (Optional) Email Address (Optional) How would you rate your overall visit? Excellent Very Good Average Not so good When your appointment was over did you have a good understanding of your dental situation? Yes Not Really I wish I knew more about my situation Were your financial options explained to you? Yes No I already understand my financial options Did you have to wait over 15 minutes past your appointment time to be seated? If so, how long? No 15 to 30 minutes 30 to 45 minutes Over 45 minutes Did the staff greet you properly? Yes No I don’t recall Would you refer your friends and family to us? Yes No I’m not sure Please comment on how we could make your visit better, new services you would like to see, or other ways we can make you feel more comfortable. Press this button to submit your survey. Thank you for taking the time to let us know how your appointment went.
