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BANDS OFF SURVEY FOR HILLS ORTHODONTICS
Band Off Survey
Name (Optional):
First Name:
Last Name:
How would you rate the quality of the orthodontic treatment you received:
Very Good
Good
Average
PoorVery Poor
Very Poor
How would you rate the communication and care you received from the:
Orthodontists:
Very Good
Good
Average
Poor
Very Poor
Surgery Staff:
Very Good
Good
Average
Poor
Very Poor
Reception and Office Staff:
Very Good
Good
Average
Poor
Very Poor
What do you like about our office?:
What do you dislike about our office?:
Is there anything we could have done to make the treatment easier or more pleasant for you?:
Will you recommend our office to your family, friends and neighbours:
Most Definately
Definately
Maybe
No
Definately Not
Additional Comments:
Thank you for taking the time to complete this quesitonaire. Your input is important to us.
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Our location
What are 'invisible braces'?
Treatment options
Early Intervention
Adolescent Orthodontics
Adult Orthodontics
Surgical Orthodontics
Types of Braces
Invisible Braces
Lingual Orthodontics
Invisalign
Removable Plates
Treatment information
What is Orthodontics
Your First Visit
New Patient Questionnaire
Payment Options
FAQs
Patient information
Information Brochures
Practice Profile
Appliance Care
Orthodontic Troubleshooting
Links
Bands Off Survey
Doctor information
Online Referrals
Mouthing Off Newsletters
Handy links
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Orthoworld Group
ABN 56 385 589 852