top of page
About
The Team
Book Online
Services
Early Treatment
Teen Orthodontics
Clear Aligners
Adult Orthodontics
TMD Treatment
Airway Orthodontics
Accelerated Orthodontics
Extreme Orthodontics
Cleft Palate Correction
Patients
Insurance Plans
Appliances Instructions
Testimonials
After Consult Form
Special Offers
1,000$ Off Invisalign
Essential Workers
Free Screenings
HRH Staff Members
Contact
More
Use tab to navigate through the menu items.
551 900 6200
Free Consultation
After Consult Questionnaire
How would you rate your experience with our practice?
*
How long did you wait to be seen for your consultation?
*
0-15 min
15-30 min
more than 30 min
Were all staff members polite and respectful?
*
Yes
No
Comments
Did you understand the Orthodontist’s treatment recommendation?
*
Yes
No
Comments
Were all your questions regarding your treatment answered?
*
Yes
No
Comments
What deters you the most from starting Orthodontic treatment? (Choose all that apply.)
*
Aesthetics impact
Discomfort of treatment
Length of treatment
Professional life demands
Finances (downpayment)
Finances (monthly installments)
Was the financial breakdown thoroughly explained to you?
*
Yes
No
Comments
How important is it for you to get a second opinion?
*
Very important
Somewhat important
Not necessary
What could we improve upon to offer a better consultation experience?
Submit
bottom of page