EmailMeForm
How Did We Do?
Name
First
Last
Email
Do you feel that you and/or your child received adequate personal attention from us?
Yes
No
Comments:
Did the office environment meet your expectations?
Yes
No
Suggestions:
Was the staff caring and supportive?
Yes
No
Were the details of your condition and recommended treatment explained to your satisfaction?
Yes
No
Are you happy with you/your child's treatment results?
Yes
No
Comments:
Were the cost of treatment, insurance issues, and payment options clearly explained?
Yes
No
Suggestions:
We try to treat our patients so well that they will want to recommend us to their friends and family. Did we achieve this with you?
Yes
No
Please provided any additional comments that may help us serve others better:
Suggestions:
