As we strive to consistently improve our services at Fox Family Dental, we seek your sincere feedback. Please help us by taking a few minutes to answer the following questions:

How did you hear about us?
Date of last visit:
Did you have an appointment?
Did you find our working hours convenient for you?

Did you find our parking convenient?

Upon entering our clinic, were you properly greeted and acknowledged by our staff?
Did the waiting area look clean and orderly?
How long did you wait before being seen by the dentist?
Was the receptionist helpful, polite and pleasant?
Was the dental assistant(s) friendly, supportive and confident?
Was the dentist who attended you confident and focused?
Did the dentist explain your treatment, answer your questions and listen to your concerns?
Did the procedure room seem clean and hygienic?
The level of dental treatment I received was:
How would you rate the overall quality of service you received at Fox Family Dental?
Would you recommend us to your family, friends and co-workers?
Additional Comments or Suggestions:
If this is a complaint, do you wish to be contacted for follow-up?
The following information is optional, but is required if you wish to be contacted:
Email Address
Day Phone
Evening Phone