1. Default Section

At what time were you seated for your appointment?

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* 1. At what time were you seated for your appointment?

What did you like most about your visit?

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* 2. What did you like most about your visit?

What did you like the least about your visit?

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* 3. What did you like the least about your visit?

Did our team members improve your dental knowledge and communicate in a friendly, polite and courteous manner?

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* 4. Did our team members improve your dental knowledge and communicate in a friendly, polite and courteous manner?

How would you rate the thoroughness of the doctor’s treatment?

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* 5. How would you rate the thoroughness of the doctor’s treatment?

How would you rate the thoroughness of the hygienist’s and assistant's treatment?

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* 6. How would you rate the thoroughness of the hygienist’s and assistant's treatment?

Was your treatment comfortable?

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* 7. Was your treatment comfortable?

Did we inform you (prior to treatment) of estimated costs?

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* 8. Did we inform you (prior to treatment) of estimated costs?

Was your visit to our office a pleasant and positive experience?

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* 9. Was your visit to our office a pleasant and positive experience?

How can we improve our service to you?

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* 10. How can we improve our service to you?

Would you recommend our practice to family and friends?

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* 11. Would you recommend our practice to family and friends?

Would you like to leave comments with Dr Kitzmiller concerning you treatment?

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* 12. Would you like to leave comments with Dr Kitzmiller concerning you treatment?

This survey is anonymous, but if you would like to speak to Dr Kitzmiller about your visit, please give us your contact information below.

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* 13. This survey is anonymous, but if you would like to speak to Dr Kitzmiller about your visit, please give us your contact information below.

Thank you for sharing your honest opinions and concerns in this evaluation. Can we improve our survey? Please comment below:

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* 14. Thank you for sharing your honest opinions and concerns in this evaluation. Can we improve our survey? Please comment below:

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