River Valley Smile Center, Arkansas Cosmetic Dentist, Tooth Whitening Fort Smith Arkansas,
River Valley Smile Center, Arkansas Cosmetic Dentist, Tooth Whitening Fort Smith Arkansas, River Valley Smile Center, Arkansas Cosmetic Dentist, Tooth Whitening Fort Smith Arkansas, River Valley Smile Center, Arkansas Cosmetic Dentist, Tooth Whitening Fort Smith Arkansas, , Arkansas Dentist, Dentist Fort Smith Arkansas, Arkansas Cosmetic DentistTooth Whitening Fort Smith Arkansas, Porcelain Veneers Arkansas, Arkansas Cosmetic Dentist, Tooth Whitening Fort Smith Arkansas, Tooth Whitening Fort Smith Oklahoma, Porcelain Veneers Arkansas, Dental Veneers Arkansas, Arkansas Dentist, Dentist Fort Smith Arkansas, Dental Veneers Arkansas, Arkansas Dentist, Dentist Fort Smith Arkansas, River Valley Smile Center, Arkansas Dentist, Implant Dentist Fort Smith, Arkansas Cosmetic Dentist, Dental Veneers Arkansas, Arkansas Dentist, Dentist Fort Smith Arkansas, Dental Veneers Arkansas, Arkansas Dentist, Dentist Fort Smith Arkansas, , Arkansas Dentist, Dentist Fort Smith Arkansas, Arkansas Cosmetic DentistTooth Whitening Fort Smith Arkansas, Porcelain Veneers Arkansas, Arkansas Cosmetic Dentist, , Arkansas Dentist, Dentist Fort Smith Arkansas, Arkansas Cosmetic Dentist

Dental Patient Survey

We appreciate you taking the time to complete our survey. Please feel free to comment on your visit as well. Any comments you choose to make are kept strictly confidential and can only help us become better in the future.

*Patient name

*E-mail address

How would you rate your overall visit?
Excellent Very Good Average Not so good

When your appointment was over did you have a good understanding of your dental situation?
Yes Not really I wish I knew more about my situation

Were your financial options explained to you?
Yes No I already understand my financial options

Did you have to wait over 15 minutes past your appointment time to be seated? If so how long?
No 15 to 30 minutes 30 to 45 minutes Over 45 minutes

Did the staff greet you properly?
Yes Not really I don't recall

Would you refer your friends and family to us?
Yes No I'm not sure

Please comment on how we could make your visit better, new services you would like to see, or other ways we can make you feel more comfortable.

* Required
River Valley Smile Center, Arkansas Cosmetic Dentist, Tooth Whitening Fort Smith Arkansas,
River Valley Smile Center, Arkansas Cosmetic Dentist, Tooth Whitening Fort Smith Arkansas,

Home | About Our Cosmetic Dental Team | Dental Services | Dental Smile Gallery
FAQs | Links | Dental Newsletter | Dental Patient Survey | Patient Forms | Ask Dr. Becker
Dental Appointments | Contact Our Cosmetic Dental Team | Email Us
Arkansas Cosmetic Dentistry | Site Map

©2005 River Valley Smile Center
Site designed and maintained by TNT Dental

Cosmetic and general dentist serving Fort Smith, Arkansas. We also
offer sedation dentistry, tooth colored fillings, veneers, whitening, implant dentistry and
treatment of Gum Disease. Serving the Fort Smith, Arkansas and Oklahoma area.