Patient Survey

We appreciate your time in taking this short survey on our performance and your experience out this Dental Health practice. This helps us create better experiences for you the patient. All information is confidential. Thank You.

Name: (optional)
Email: (optional)

How would you rate your overall visit?
Excellent
Very Good
Average
Not Good

When your appointment was completed did you have a good understanding
of your dental situation?
Yes
Not really
I wish I knew more about my dental situation

Was your financial obligation explained to you?
Yes
No

Did you wait over 15 minutes past your scheduled appointment? If so, how long?
No
15 - 30 minutes
30 - 45 minutes
Over 45 minutes

Did our staff, including front desk, assistants and doctors greet you properly?
Yes
Not Really
I don't recall

Would you refer a friend or family member to us?
Yes
No


Please comment on how we met your expectations or how me may make your visit better, service you would like offered, or other ways we can make you feel more comfortable.