Survey Questionnaire Dr Allahyar Geramy Home Page / Survey Questionnaire "*" indicates required fields First Name and Last Name*The type of relationship you have with this officeThe patient is being treatedPatient visitPatient under observationPatient after the end of treatmentE-mail* Phone CallWhat is your opinion about the quality of services provided in the office? Excellent Good Medium Weak Have your goals at the orthodontic clinic been met? Excellent Good Medium Weak Did you feel comfortable in the office? Excellent Good Medium Weak Has the speed of treatment progress been optimal? Excellent Good Medium Weak Are your appointments regularly scheduled? Excellent Good Medium Weak What do you think can increase the quality of service in this office?Please enter the characters you see in the image in the box below: