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.
2.Did your child bring home a dental kit after their visit?
3.Did you get an information card about your child's visit? (From inside the kit)



4.Did your child have a good or bad response to seeing the dentist at school?
5.Would you sign up your child again?
6.How likely would you recommend this program to another parent or guardian?
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.