Give Us Your Feedback
We improve when we know what we are doing right and what could be better.

     Your input into how we are doing is invaluable to us. We strive to provide the quality of care you would expect from any dental office focused on excellence. More then that, our goal is to provide you the highest value available in dentistry in all of the Chicago area. To do this we need your feedback. Please take a few minutes and answer the questions below to help us gauge how well we are doing and how much you like our "comfortable and affordable" approach to dentistry.

Thank you for your help!

Dr. D.

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Name *
E-mail Address *
I had a _______ experience in your office. (please select the best word to fill in the blank)
I was greeted warmly when I arrived.
All financial issues were adequately explained to me before any treatment was done.
Rate the front office staff: (best answer please) They were highly effective and positive
They did a fair job
They were O.K. but could improve
They were uncooperative and negative
The staff assisting the dentist chairside: (best answer) Was great!
Did a good job
Was Fair
Definitely need talking to
Tell us about your experience in our office
I would recommend your practice _______. (please complete) Highly to everyone!
Somewhat although I wish somethings were done better.
Never.
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