School-Based Dental Survey
East Hill Medical Center wants to hear about your child's visit at our dental clinic. This information will be used to help with quality of services provided by our team.
1.
Please select your child's school.
CAP: Head Start
Casey Park Elememntary
Cato-Meridian Elementary
Elbridge Elementary
Genesee Elementary
Herman Ave. Elementary
Owasco Elementary
Port Byron Elementary
Seward Elementary
Southern Cayuga Elementary
Union Springs Elementary
2.
Did your child bring home a dental kit after their visit?
Yes
No
3.
Did you get an information card about your child's visit?
(From inside the kit)
Yes
No
4.
Did your child have a good or bad response to seeing the dentist at school?
Good
Bad
Neither good or bad
5.
Would you sign up your child again?
Yes
No
6.
How likely would you recommend this program to another parent or guardian?
I would recommend
I somewhat recommend
I somewhat do not recommend
I would not recommend
7.
Please add any comments below.
If you have any questions, please call (315) 253-8477, Prompt: 4, to speak with our dental office. Our office hours are Monday through Thursday, from 7:30 a.m. to 6:00 p.m. Messages left after hours will be addressed on the next business day.