YOUR DENTIST SURVEY

Combined with feedback from other patients, your survey responses will be used to update your dentist's profile.

*What is the full name of your dentist? In which state is your dentist's office located? AL AK AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC NE NH NJ NM NV NY ND OH OK OR PA RI SC SD TN TX UT VT VA WA WI WV WY *How many years have you been a patient of this dentist? *What is the approximate distance of your typical commute to the dentist's office?   Less than 15 miles ✔    Less than 15 miles ✔

  More than 15 miles ✔    More than 15 miles ✔ *Are there other members of your household or immediate/distant family who also go to your dentist?   Yes ✔    Yes ✔

  No ✔    No ✔ * Does your dentist usually treat one patient during an appointment or more than one?   One patient ✔    One patient ✔

  More than one ✔    More than one ✔ * Would you describe your dentist's treatment preferences and style as "Conservative", "Comprehensive", or somewhere "In-Between"?

🛈 'Conservative' treatments involve minimally invasive procedures focused on preserving healthy tooth structure and monitoring certain conditions instead of treating them immediately.
'Comprehensive' dental treatments aim to keep the patient's oral health in a good condition in the long run and prevent potential future dental problems sooner rather than later.

  Comprehensive ✔    Comprehensive ✔

  Conservative ✔    Conservative ✔

  In-Between ✔    In-Between ✔ Which dental insurance did you use in the last 12 months? (Optional)   Aetna ✔   Aetna ✔   Anthem/BCBS ✔   Anthem/BCBS ✔   Cigna ✔   Cigna ✔   Delta Dental ✔   Delta Dental ✔   Guardian ✔   Guardian ✔   Metlife ✔   Metlife ✔   United Healthcare ✔   United Healthcare ✔   Medicare ✔   Medicare ✔ If you used other dental insurances, please add them below ... Is your dentist listed on the website of the dental insurance you used? (Optional)   Yes ✔    Yes ✔

  No ✔    No ✔ Is there anything else you would like to share about your experiences with your dentist? (Optional) Would you like us to notify your dentist that you have participated in this survey? If yes, please enter your name. (Optional) Submit Survey