OUR OFFICE

HOW ARE WE DOING?

Which dentist did you visit? (Required)

What was the date of your visit?

Do you usually wait more than 15 minutes
for a scheduled appointment?

During your appointment, does your dentist appear familiar with your chart and dental history?

Does your dentist explain why treatment is recommended?

Does your dentist answer your questions and explain things clearly?

Does your dentist spend enough time with you?

Are you treated courteously and respectfully by your dentist and staff?

Do you see your dentist as being approachable, sympathetic, and understanding?

Does the dentist make sure you are comfortable during treatment?

Your Hygienist

Which hygienist worked with you during your visit? (Required)

What was the date of your visit?

Do you usually wait more than 15 minutes
for a scheduled appointment?

During your appointment, does your Dental Hygienist appear familiar with your chart and dental history?

Does your Dental Hygienist explain why treatment is recommended?

Does your Dental Hygienist answer your questions and explain things clearly?

Does your Dental Hygienist spend enough time with you?

Does the Dental Hygienist make sure you are comfortable during treatment?

The Office

Is the office clean, comfortable and professional in appearance?

Is adequate parking available?

Is there a variety of appropriate reading material available in the reception area?

Is the telephone answered promptly?

Are you able to get an appointment in what you consider to be a reasonable amount of time?

Does the office staff assist you in filling out insurance and other forms?

Does the office staff maintain your privacy when discussing financial arrangement and other personal matters with you?

Does the office staff notify you if appointments are running behind schedule?

Would you refer your friends and family to Westlake Smile Design?

Have you referred any patients to Westlake Smile Design?

Full Name (Optional)

Email Address (Optional)

Phone Number (Optional)

We would greatly appreciate any additional feedback::

10 + 6 =

State-of-the-art, friendly, professional, and very nice people.
Nothing but good things to say about Westlake Smile Design.

Great Cleaning! My teeth required a lot of work during the cleaning because I missed several months since my last visit. The entire session was still amazingly comfortable. The hygienist was tremendously skillful to get the job done without causing any discomfort.

Brian J.

The staff and Dentist were informative. I received more information from the Dentist then my past Dentist. He informed me of my options and gave me a simple plan to get the services done. The office staffed worked with my insurance. Wonderful Experience !

Rosalinda H.

Dr. Eben is very pedantic in his assessment and inspection. He was very clear what needs to be corrected. I liked his feedback if he was in my place. Very gentle hands. He gave me two options to ponder. Very well mannered and articulate. Yes, I would recommend him.

Gary C

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HOW ARE WE DOING?

Your Hygienist

The Office

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