Take Our Survey

Patient name

E-mail address

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
Not really
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.