Dental Patient Survey ~ Dr's Carmi and Knoll,D.D.S., P.C., Washington DC, an advanced and comprehensive dental care and cosmetic dentistry team in the District of Columbia

CarmiAndKnoll.com ~ Dr's Carmi and Knoll,D.D.S., P.C., an advanced and comprehensive dental care team in downtown Washington DC

	Dental Patient Survey


We would like to Thank YOU for selecting Carmi & Knoll Dental as your dental practice. Please let us know how we are doing in the following areas. [Printer Friendly Version (PDF)]
Who were you here to see today?
		Dr. Carmi
		Dr. Knoll

Were you seated on time for your appointment?
		Yes
		No
		1 to 5 minutes
		5 - 10 minutes
		10 - 15 minutes
		Over 15 minutes

Did the staff greet and advise you properly?
		Yes
		Not Really
		No
		I do not remember

When your appointment was over, did you have an understanding of your diagnosis and treatment needed?
		Yes
		Somewhat
		No
		Need to know more

Were your billing questions and financial options adequately explained to you?
		Yes
		I already understand
		No
		Need to know more

How do you rate our preventive dentistry and hygiene care?
		Excellent
		Good
		Fair
		Needs Improvement

How do you rate our restorative and major dental care?
		Excellent
		Good
		Fair
		Needs Improvement

How would you rate your overall visit?
		Excellent
		Very Good
		Average
		Needs Improvement

Will you refer Carmi & Knoll Dental to your friends and family?
		Definitely, Yes
		Maybe
		No
		I'm not sure yet

We appreciate any additional comments or recommendations you have on individuals, things we could change, new services you would like, or other ways to make you enjoy your dental experience.

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	Carmi & Knoll DDS., P.C. 818 18 th St., N.W. Suite 700 Washington , DC 20006	Smile@CarmiAndKnoll.com Voice: (202) 659-8020 Fax: (202) 659-0049