Patient Survey

We would like your name and email address, so we can respond to your survey, but it isn’t required.



How would you rate your overall visit?

When your appointment was over did you have a good understanding of your dental situation?

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?

Did the staff greet you properly?

Would you refer your friends and family to us?

Press this button to submit your survey. Thank you for taking the time to let us know how your appointment went.

Elma Family Dental