PATIENT SURVEY
Your Comments are Appreciated
 

What was the primary purpose of your dental visit?             Emergency Dental Visit             New Patient visit including exam, x-rays, and cleaning             Routine Check up and cleaning visit             Dental Treatment with the hygienist or doctor

Service: Excellent Good Fair Poor Comments:

Attitude: Excellent Good Fair Poor Comments:

Facility: Excellent Good Fair Poor Comments:

Dental Treatment: Excellent Good Fair Poor Comments:

If you required further assistance from our staff during your visit, did we respond to your satisfaction? Yes  No  If not, please call my office and speak with Martha (904) 268-2011 or e-mail me (Dr.Z) Comments:

Assuming that you will need dental services in the future, would you choose to visit again at a Smile resort?                                                                                                                 Yes  No  Comments:

During your dental visit, did you encounter an employee who provided exceptional Smile Resort service?

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