Patient Survey

We appreciate you taking the time to complete our survey. Please feel free to comment on your visit as well. Any comments you choose to make are kept strictly confidential and can only help us become better in the future.

Patient name
E-mail address
How would you rate your overall visit?
Excellent
Very Good
Average
Not so good
When your appointment was over did you have a good understanding of your dental situation?
Yes
Not really
I wish I knew more about my situation
Were your financial options explained to you?
Yes
No
I already understand my financial options
Did you have to wait over 15 minutes past your appointment time to be seated? If so how long?
No
15 to 30 minutes
30 to 45 minutes
Over 45 minutes
Did the staff greet you properly?
Yes
Not really
I don’t recall
Would you refer your friends and family to us?
Yes
No
I’m not sure
Please comment on how we could make your visit better, new services you would like to see, or other ways we can make you feel more comfortable.

Why Choose Us?

  • Full Service Dentistry
  • State-Of-The-Art Dental Care
  • Lumineers Certified Dentist
  • Hablamos Español
  • We Accept Most PPO Insurances
  • Quality Care
  • Comfortable Environment
  • Emergency Services
  • Personalized Service