We have put much time and effort into developing a site that would be informative and enjoyable (especially for a dental group!!). Your comments would be greatly appreciated. Note that there are no requirements for this form. You may give us as much or as little information as you wish.

If you choose, you may email us rather than use this form.

The Doctors and Staff of South Shore Dental Group
Are you currently a
patient of South Shore Dental Group?		 yes
no
How did you find
this site?

Knew about it from office mailings
Told by a friend
link from another dental site
link from Yahoo, AOL, other search engine
Did you find
his site informative?		 very
moderately
slightly
not as good as expected
disappointing
Did you find what you were looking for? yes
no
Did you call the office as a result of our site? yes
no
Would you recommend this site to a friend or colleague? yes
no
Would you consider
becoming a patient
as a result of our site?		 yes
no
not sure
Your additional
comments are
appreciated
e-mail address (mailname@your provider.com)