By submitting this form, you are agreeing to allow us to publish your survey on our website and social media channels.

Were financial arrangements discussed in a courteous and clear manner at check-out?
Were you greeted courteously and promptly at check-in?
Was this your first visit?
Were you given a verbal explanation of the anticipated procedure by the doctor or the assistant?
Did the surgical assistant introduce himself/Herself To You?
Was the surgical assistant knowledgeable?
Was the surgical assistant friendly/personable?
Was the surgical assistant gentle?
Did the doctor introduce himself/herself to you?
Was the doctor knowledgeable?
Was the doctor friendly/personable?
Was the doctor gentle?
Was there enough time with the doctor/surgical assistant to have your questions answered and concerns addressed?
Was the examination room clean and neat?
Will you return for additional care if needed?
Would you recommend us to a friend?
Would you like to receive a call from our Practice Administrator regarding your experience?
By Clicking the "Yes" button you agree to allow us to publish your survey on our website and social media channels using your first name and last initial. *Required