Dear Valued Patient,

The doctors and staff at Associated Orthodontists appreciate your business and thank you for choosing us for your orthodontic treatment.

In order to maintain our high level of service, we ask that you take a moment to complete the attached survey regarding our practice. We value your opinion and welcome your comments and suggestions.

Sincerely,
Dr. Bratcher, Dr. Casey, Dr. Cortopassi & Dr. Soderquist

To download a pdf of this survey, Click here .
Office Location
1. The overall quality of care you received:
 
 
2. Your satisfaction with the process of your treatment:
 
 
3. How would you describe Dr. to friends and family:
 
 
4. The ease of getting through to the office phone:
 
 
5. The courtesy of the telephone receptionist:
 
 
6. Our office hours are:
 
 
7. Timeliness of your appointment:
 
 
8. The front desk staff’s communication (explanation of policies, instructions):
 
 
9. The front desk staff’s personal manner (sensitivity, courtesy, respect):
 
 
10. The front desk office staff’s responsiveness to your concerns:
 
 
 
11. Orthodontist’s communication (explanation of treatment, instructions):
 
 
12. Orthodontist’s personal manner (sensitivity, courtesy, respect):
 
 
13. Orthodontist’s responsiveness to your concerns:
 
 
14. Clinical Assistant’s communication (explanation of treatment, instructions):
 
 
15. Clinical Assistant’s personal manner (sensitivity, courtesy, respect):
 
 
16. Clinical Assistant’s responsiveness to your concerns:
 
 
17. The office appearance has been:
 
 
18. Your treatment experience has been:
 
 
19. You feel at home in our office:
 
 
   
 
Testimonials:
Please share your comments with us. If you would like, please leave your name so that we may incorporate your comments into our testimonials on our website.
Why did you choose us for your Orthodontic treatment? How can we improve?
   
What impresses you? Additional comments or suggestions:
Name
(Optional)
 
May we use your testimonial on our website: