Patient Survey | LaRue Orthodontics

How would you rate your overall visit?

Excellent

Very Good

Average

Not Good

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

Yes

No

I wish I knew more about my situation

Were your financial options explained to you?

Yes

No

I already understand my financial options

Did you have to wait over 15 minutes past your appointment time to be seated? If so how long?

No

15 to 30 minutes

30 to 45 minutes

Over 45 minutes

Did the staff greet you properly?

Yes

No

I do not recall

Would you refer your friends and family to us?

Yes

No

I am not sure

Your Name

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Email Address

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Additional Comments

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