Patient Survey

Patient Name:
Email:
How would you rate your most recent visit overall?
Were you greeted promptly and pleasantly upon your arrival to the office?
Were you seated for your appointment on time? If not, were you kept properly informed of the change to your appointment time? How long was your appointment delayed?
Do you feel like you have a good understanding of your oral health and your treatment options?
Were your payment options and insurance benefits explained well to you?
Do you feel like the Dr. Kalarickal or empowered team members offered you the time you needed for your treatment questions?
Would you recommend your friends and family to us?
Which team member encouraged you to complete this survey?
Please advise us on any ways we can improve our service for you and your family and on anything we are doing well currently.
May we utilize your comments as a testimonial on our webpage or other practice promotion material?

Dentist Wesley Chapel – Family, Laser, and Cosmetic Dentistry for Wesley Chapel, Zephyrhills, Lutz, Land O’Lakes, and New Tampa.

"Wesley Chapel Center for Family and Cosmetic Dentistry offers cosmetic and laser dentistry, Zoom! and Opalescence tooth whitening, Invisalign, CEREC, Lumineers, white fillings, nitrous oxide, metal-free crowns, veneers, extractions, root canal treatment, dentures, and many other dental services." Zacharias J. Kalarickal, DDS