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Ledford Dental Lab Satisfaction Survey
We want to know your feedback from the appliance that was delivered. This survey should only take 1 to 2 minutes to fill out! We appreciate you taking time to let us know how we are doing.
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1.
Doctor's Name
(Required.)
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2.
Patient Name
(Required.)
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3.
Appliance that was delivered
(Required.)
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4.
How satisfied was the patient with the fit of the appliance?
(Required.)
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
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5.
How satisfied was the patient with the appearance of the appliance?
(Required.)
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
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6.
How satisfied were you with the timeliness of pickup and delivery of the appliance?
(Required.)
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
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7.
How satisfied were with the communication from the Ledford Team throughout the process to completion of this applicance?
(Required.)
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
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8.
Overall, how satisfied or dissatisfied are you with the experience on this patient's case?
(Required.)
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
9.
Although, not required, do you have any last statements for the team at Ledford?