| How satisfied were you with your services for today?
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| How satisfied were you with the cleanness of the office? |
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| How satisfied were you with the amount of time the Doctor spent explaining your treatment? |
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| How satisfied were you with the staff and how you were greeted when you came in? |
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| How likely are you to recommend our dental office? |
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| How satisfied were you with the treatment you received today? |
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| How likley are you to come back to this office? |
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| How satisfied were you with the amount of time the Hygienist spent on your treatment? |
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| What could we have done to make your experience better. |
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| What is one thing you would have changed about your appointment today? |
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