Name * First Name Last Name Phone * (###) ### #### Email * Please answer the following questions to the best of your ability regarding today's visit. * I felt comfortable and at ease during my visit. Strongly Disagree Disagree Neutral Agree Strongly Agree The Doctor seem knowledgeable and understanding of my dental concerns. Strongly Disagree Disagree Neutral Agree Strongly Agree My smile is better after being treated by Dr. O and I feel more informed about my dental health Strongly Disagree Disagree Neutral Agree Strongly Agree What makes Dr. O different from other dentists you have seen for treatment? *
