Patient Name:
E-Mail Address:
How would you rate your overall visit?
Excellent
When your appointment was over did you have a good understanding of your dental situation?
Yes
Were your financial options explained to you?
Did you have to wait over 15 minutes past your appointment time to be seated? If so, how long?
No
Did the staff greet you properly?
Would you refer your friends and family to us?
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.
Florissant 4585 Washington ~ Suite C2 Florissant, Missouri 63033 Phone: 314-837-2120 Fax: 314-838-8400 Email: office@smilesbychoice.com
St. Charles 2665 West Clay St. Charles, Missouri 63301 Phone: 636-946-6253 Fax: 636-946-7687 Email: office@smilesbychoice.com
