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TOOTHFAIRY CLIENT FEEDBACK FORM
Feedback form
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1.
How would you rate the customer service received at your appointment? (10 completely satisfied) (1 unsatisfied)
(Required.)
1
2
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5
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7
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10
2.
How would you rate your results received at your appointment?
Better than expected
Exactly as expected
Not as good as expected but still satisfied
I was unsatisfied with my results
3.
In your own words how would you describe how you felt during the appointment and anything that could improve?
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4.
Would you recommend LaserX to friends and family who were interested in Teeth Whitening?
(Required.)
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5.
How have you felt since your appointment?
(Required.)
My overall confidence has improved
I feel more comfortable smiling in photos/ having conversations/ smiling
I feel the same
6.
Lastly, Did you feel your appointment was good value for money?
7.
Did you have any of the following side effects?
Tooth Sensitivity
Dry Mouth
Gum Irritation
No side effects