We appreciate you taking the time to complete our survey and commenting on how we could make your visit better or other ways we can make you feel more comfortable.

	*First Name: *Last Name: *E-Mail Address: 1. How would you rate your overall visit? Excellent Very Good Average Not So Good 2. 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 3. Were your financial options explained to you? Yes No I already understand my financial options 4. 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 5. Did the team greet you properly? Yes Not Really I Don't Recall 6. Would you refer your friends and family to our practice? Yes No I'm Not Sure Comments: