Dental Care Survey

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1. Please include your information to receive a $10 discount off your next dental visit co-pay and to enter to win our next drawing.
2. Are you a NEW patient at our office?
3. What made you choose us as your dental office?
4. What was the purpose of your last visit to our office?
5. How do you rate us in the following areas?
ExcellentGoodFairPoorBadN/A
Office location
Parking convenience
Business hours
Friendliness of business staff
Friendliness of Christie and Dr. Kazanis
Friendliness of hygienist (Tammy)
Skill and explanations from your hygienist
Skill and explanations from Dr. Kazanis
Skill and explanations from the dental assistant (Christie)
Pain control by Dr. Kazanis
Pain control during your cleaning visit
Cost of services
Ease of appointment scheduling
Handling of your insurance
Explanation of treatment options
Financial options available to you
Office cleanliness
Presentation of treatment plan
6. In which areas does our staff make you feel comfortable?
7. What can we do to improve your visit to our office?
8. Would you recommend us to your friends and family?
9. What could we do to thank you for your referral?
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