How would you rate your overall visit?	Excellent Very Good Average Not So Good
When your appointment was over did you have a good understanding of your dental situation?	Yes No I Wish I Knew More About My Situation
Were your financial options explained to you?	Yes No I Already Understand My Financial Options
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
Did the staff greet you properly?	Yes No Do Not Recall
Would you refer your friends and family to our dental office?	Yes No Not Sure
Are there any other comments you would like to make regarding your appointment or our dental office?
We'd appreciate it if you would take a moment to review our practice by rating us and providing a brief description of your overall experience. Thank you for giving us your feedback.	(Excellent) (Good) (Fair) (Poor) (Bad)