Accepting New Patients!
©2004-2010 Joan Werleman, DDS PC Site design and hosting by: QPi Graphics	We welcome your comments and suggestions about your recent visit. Date of visit:   How satisfied were you with the ease of the appointment process? Extremely Satisfied Satisfied Not Satisfied Not applicable for this visit How were you greeted upon arrival? Friendly No Greeting Not Friendly Were you seen at your appointment time? On Time Early 15-30 min. late 30-60 min. late 1 hour or more late How interested was the staff in meeting your needs? Very Interested Interested Not Interested Were you satisfied with the time the doctor spent with you? Extremely Satisfied Satisfied Not Satisfied Not applicable for this visit Did the doctor answer your questions to your satisfaction? Yes No Did you receive complete information concerning insurance coverage, co-payments, and fees? Yes No Would you recommend us to a friend, family member or colleague? Yes No If there was one thing we could do to improve our quality of care or service, what would it be?