Smile Design - Unique - Like Your Fingerprint
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Comment Form

We enjoy having you as a patient and we are committed to making our relationship together as fulfilling as possible. In order to continue to serve happy patients, we ask for your suggestions and comments about our services.

Please fill out the form below and click the SUBMIT button to send us your comments. Because your comments are sent over the Internet, please do not include sensitive or personal information on this form.

1. Are you pleased with how you and/or your family were treated by our dental team?

yes no

Comments:

2. Did you think that our doctor(s) and team fully explained your treatment options, instructions, and questions?

yes no

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3. Did you think that our team was ready and eager to assist you?

yes no

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4. Are there any areas in which our service could be improved?

yes no

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5. Our practice values happy, satisfied patients and our success is based on our patients' recommendations. Can we count on you to refer your friends and family to us for their dental needs?

yes no

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