Portland Dentist                                                                                                                          Portland Dentist
Portland Dentist



Portland Dentist

Refer a Friend Offer

If you refer a friend, both you and your friend will receive a $25 gift card for a local business.

New Patient Offer

Mention this ad, and receive a $25 gift card with a new patient exam and xrays.

Offers Expire:
Feb 10 2012



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  Patient Survey
       

Please take a moment to complete our survey.  Your comments are welcome and completely confidential. Your input will help us improve our service.  Thank you.

We appreciate you taking the time to complete our survey. Please feel free to comment on your visit as well. Any comments you choose to make are kept strictly confidential and can only help us become better in the future.

Patient Name :
E-mail Address :
Date of your last visit:
How was the treatment you received :
How comfortable were you during the treatment you received :
Was your treatment explained to you so that you have a clear understanding of your dental situation :
Were your financial options explained to you? :
How long did you wait before being seated in a room?
Would you refer your friends and family to us? :
Please comment below on how we could make your next visit better and more comfortable.  Thank you.:


 
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Portland Dentist      Portland Dentist
Portland Dentist      Portland Dentist
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