We would appreciate your comments. We know that you have high expectations of us and we need to know how we are doing. Thank you very much for taking the time.                           - Dr. Doran and the Riehl Team

Date of your visit: 2/7/2012 
Did you see Dr.Riehl Yes No Assistant's Name
Did you see hygienist Yes No Hygienist Name
Please Rate The Following
1. Was your visit comfortable Perfect Okay Missed the boat
2. Was your time valued? Perfect Okay Missed the boat
3. Were we friendly and respectful? Perfect Okay Missed the boat
4 Were your expectations met or exceeded Perfect Okay Missed the boat
5. Were you informed to your satisfaction regarding your treatment? Perfect Okay Missed the boat
6. Were you listened to and your concerns addressed? Perfect Okay Missed the boat
7. Were your financial concerns addressed? Perfect Okay Missed the boat
Please explain how we can improve
Your input is important to us, please include any further comments:
Would you recommend us to your family and friends? Yes No
If this was your first visit, what brought you in?
Friend
Relative
Yellow Pages
Impact Directory
Website
Other
Name (Optional)

Thanks again.
Dr. Doran Riehl and the Riehl Team

       
   
 
1016 South 40th Avenue | Yakima, WA 98908 | 509-966-3880
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