1. Please rate the appearance/impression of the following areas:Waiting Room 5 4 3 2 1 CommentsTreatment Rooms 5 4 3 2 1 CommentsReception Desk 5 4 3 2 1 CommentsConsultation Room 5 4 3 2 1 CommentsPlease rate the appearance and professionalisim of our front desk team 5 4 3 2 1 Please rate your observations as it pertains to our front desk team (specific team members will be helpful)Please rate the appearance and professionalism of Dr. Simon's assistants 5 4 3 2 1 Please relate your observations as it pertains to Dr. Simon's assistants (specific team members will be helpful)Please relate your observations as it pertains to Dr. Simon 5 4 3 2 1 Please rate the effectiveness of our appointment phone call reminder system 5 4 3 2 1 CommentsDid you enjoy your experience at this website? Yes No Did you know that you could register online to gain access to your personal account information? Yes No How satisfied are you with the availability of appointment times? 5 4 3 2 1 CommentsHow do we rate with regards to keeping on time for your scheduled appointments? 5 4 3 2 1 CommentsIf you needed extra assistance with treatment (emergency appointment), how would you rate the response of Dr. Simon and/or Team? 5 4 3 2 1 N/A CommentsHow would you rate the way in which the treatment plan was explained to you? 5 4 3 2 1 CommentsHow satisfied were you with our policy on financial arrangements? 5 4 3 2 1 CommentsBased on your experience, how likely are you to recommend our office to family or friends who need orthodontic treatment? Would Recommend Unsure Would Not Recommend Final CommentsCAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
