Patient Survey Form

How well do you think we did on the following?

What do you think of our website?  
Overall, how was your last visit?  
The dental treatment you received was?  
Do you like listening to music during dental treatment? If so, what type of music do you enjoy listening to?
Do you like the massage chair on during treatment?
Do you like the hot towelettes after dental treatment?
Did you find our team members friendly and helpful? 
How would you evaluate the cleanliness of our office?  

The information and explanation of your

dental condition and treatment options was...
The information about your financial obligations was...
Did you help yourself to Beverages and Snacks at the Welcome Station in our Reception Area?
Have you received information about our Care-to-Share program?

Digital Xrays
Early Detection of Gum Disease
Diode Laser (for painless tissue sculpting)
Invisible Braces
In-office Whitening
Breath odor analysis
Oxyfresh products
Restylane lip enhancement and naso-labial fold filler
 
Did you find our office easily accessible?
Would you recommend us to others?
Other Comments or what would you like to tell us that can improve our service for you?
Optional  
Name
Email Address


 
 

 

 

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The Cosmetic Dental Center of the Palm Beaches - Thomas Saitta, DDS - West Palm Beach, FL 33406 - West Palm Beach Dentist,
West Palm Beach Cosmetic Dentistry, West Palm Beach Teeth Whitening, West Palm Beach Veneers, West Palm Beach Invisalign,
 West Palm Beach Dental Implants, West Palm Beach Dental Crowns, West Palm Beach Teeth Cleaning, West Palm Beach Root Canals,
West Palm Beach Inlays, West Palm Beach Dentures, West Palm Beach Lumineers, West Palm Beach Gum Surgery, Advance Consulting
Charles S. Kravitz, DDS, Performance Coach, Oxyfresh, CPT, Conservative Periodontal Therapy, Soft Tissue Management