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.

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Patient name	*
Your Email	*
Did the receptionist answer your questions and make your appointment to your satisfaction?	*	Poor Ok Good Exellent
Comment
Were you seated within 15 minutes of your appointment time, if not how long did you wait?
Did the Dr. and staff explain your treatment to your understanding?	*	Poor Ok Good Exellent
Comments
Were financial arrangements made clear and your options stated?	*	Poor Ok Good Exellent
Financial Comment
Would you refer your friends and family?	*	Yes No
If not please say why.
Additional Comments are welcome!