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1. Were you greeted with a smile? |
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2. Was our staff in the front office helpful and courteous? |
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3. Did our front end staff thoroughly explain any paperwork given? |
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4. Did our staff call you to remind you of your appointment today? |
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5. Were you seen at your scheduled appointment time? |
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Please rate your overall experience for our customer service in the front office. |
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1. Did our staff call you by name when you were brought back to the Dentist? |
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2. Was our dental assistant friendly? |
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3. Did our dental assistant review with you our dental products to help keep your teeth and gums healthy? |
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4. Did our dentist introduce himself with a smile? |
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5. Did our dentist thoroughly explain the care that he recommended? |
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6. Did the Dentist or dental assistant mention Zoom! Whitening? |
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Please rate your overall experience for your dental visit today. |
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1. Did our Hygienist greet you by your name and with a smile? |
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2. Did the Hygienist review your patient history with you? |
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3. Did the Hygienist thoroughly explain the treatment that they were doing? |
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4. Did the Hygienist recap the cleaning they did with you? |
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5. Did the Hygienist recommend preventative treatment products to keep your teeth and gums healthy? |
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6. Did the Hygienist or dental Assistant mention Zoom! Whitening? |
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Please rate your overall experience for your Hygiene visit today. |
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How would you rate your total experience at our office? |
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Would you refer your family and friends to our office? |
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We love your feedback. Please use this space for additional comments, suggestions or praise. Thank you for helping us continue to be great!
Please use the comment box to leave the contact information to any or your family and friends and receive a referral credit!
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