Thank you for your recent visit to our office. We would greatly appreciate your time in providing us your feedback to help us continue to serve our patients with excellent care!

This is a completely anonymous questionnaire. Nowhere in this questionnaire will you be asked for any identifying information.

* 1. In general, how would you rate your visit with our office today? (in case you are answering at a later date, answer all questions for your most recent visit)

* 2. How would you rate the timelines of how quickly you were seen when you came in for your appointment?

* 3. Did you feel that all your questions were answered to help you gain a clear understanding of any treatment that may be needed?

* 4. One a 1 (very bad) to 7 (very good) scale, rate the following members of our staff about your experience at the dental office.

  Did not see her today 1) Very bad 2) Needs a lot of improvement 3) Needs some improvement 4) Neither bad nor good 5) Somewhat good 6) Very good 7) Excellent
Dentist (Dr. Mahesh)
Dental Assistant
Patient Care Coordinator (Lisa)

* 5. Would you recommend our service to your friends or colleagues?

* 6. Any other suggestions or comments about your experience at our office?

Thank you for taking your time to help us make your visit a pleasant and comfortable experience. We truly value you as a patient in our practice.