End of Treatment Survey

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End of Treatment Survey

Congratulations! Now that you have completed your orthodontic journey, we need your input on how we can better serve you and future patients.  Your feedback on this questionnaire will tell us what you know about our practice as well as what you think.

5 = Excellent       4= Very Good     3= Average    2= Below Average     1= Poor

How effective and clear were we in explaining your treatment plan and any options?

Doctor         5   4   3      2    1

Team          5     4    3    2   1

Comments: 

 

Were we courteous, professional, friendly, attentive and polite?

Doctor              5        4      3       2        1

Reception/Business     5        4      3       2        1

Clinical Team         5        4      3       2    1

Comments: 

 

Was our office clean, neat and professional looking, smelling, and feeling?

5             4             3             2             1

Comments: 

 

During your examination, were we gentle, competent and careful?

Doctor   5    4      3    2     1

Team      5   4    3    2    1

Comments: 

 

Were our fees and our financial arrangements reasonable, comfortable for you?

                       5             4             3             2             1

Comments: 

 

How do you feel about the overall quality and service you received here?

                        5             4             3             2             1

Comments: 

 

What were the deciding factors in choosing where you would initiate your orthodontic care?  What could we have done better?

 

 

Your name (optional but greatly appreciated):

 

 

IN APPRECIATION FOR COMPLETING THIS SURVEY AND PUTTING YOUR NAME, YOU WILL BE ENTERED INTO OUR QUARTERLY DRAWING FOR A $50.00 GIFT CARD.

 

GIFT CARD WINNERS WILL BE SELECTED QUARTERLY AND ANNOUNCED ON FACEBOOK AND OUR WEBSITE. PLEASE CHECK OFTEN IF YOU ENTERED. GIFT CARDS WILL BE MAILED TO THE WINNER.

 

 

Thank you for your business and trust in Misuraca Orthodontics. 

 

Referrals are greatly appreciated and are the greatest form of flattery that we can receive!

 

Return in person to any of our four locations in Prairieville, Denham Springs, Central or Baton Rouge

Email: Marketing@misuracaorthodontics.com

OR

Mail to: Misuraca Orthodontics

       c/o Marketing Department

        16206 Airline Highway 

 Prairieville, LA 70769



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