Office Visit Feedback

At Bright Smile Dental Care, we strive to offer the very best in patient care. In order to provide that care we turn to our patients for advice.
Please take a moment to complete the patient survey below. We thank you in advance for your time and participation.
The information below is confidential, and will only be used to improve our service.
Was this your first visit to our office or have you been here before?

On a scale of 1 to 5, with 5 being "Great," how would you rate your experience on your last visit?
If a particular line does not apply to your visit, please skip it.

Ease of setting your appointment
Greeting by our receptionist when you arrived
Cleanliness/neatness of the waiting room
Cleanliness/neatness of the operatory
Length of waiting time
Friendliness of our office staff
Friendliness of the dentist
Quality of the service performed
Degree to which your concerns were addressed by the dentist
The ease of checking out and paying after the appointment
How likely is it that you'll recommend your family and friends?

If you would like to provide us with your contact information please use the boxes below: