Feedback

Did you feel at ease in our office?
Yes, I fell asleep
Kind of, I like it here but I still hate the dentist
No–sorry–I still don’t like dentists

Did you feel that you understood what the Doctor was explaining to you about your visit?
Yes, sign me up for dental school
Kind of, it was explained to me but I need to call back to review things
No, I will call and ask the Doctor to explain things to me better

Did you receive a follow up call from the Doctor?
Yes
No

Was there someone that made you feel good about your visit?

Was there something that you particularly liked about the office/your office visit?

Is there something that we could improve upon for your next visit?

If you have other comments, please let us know?

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