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Date
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Was our staff courteous
on the phone?
Yes
No
Was your call answered
in a timely manner?
Yes
No
Were we helpful on
the phone?
Yes
No
Did our dental team have
a professional manner and
appearance?
Yes
No
Were we kind and gentle?
Yes
No
Were you offered an
understandable explanation
of treatment?
Yes
No
Were we on time?
Yes
No
Was there something
from your visit that
especially pleased you?
Is there an area that
we need to improve?
Would you feel good
about referring a friend
or family member to
our office?
Yes
No
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