Parkville MO Dentist - Patient Survey

6320 Lakecrest Lane Parkville, Missouri 64152

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Patient Survey

Please take a moment to complete our survey. Your comments are welcome and completely confidential. Your input will help us improve our service. Thank you.

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 (optional):
E-mail Address (optional):
Date of your last visit (optional):
How was the treatment you received :
How comfortable were you during the treatment you received :
Was your treatment explained to you so that you have a clear understanding of your dental situation :
Were your financial options explained to you? :
How long did you wait before being seated in a room?
Would you refer your friends and family to us? :
Please comment below on how we could make your next visit better and more comfortable. Thank you.: Please enter code above in the field below.

Connect With Us

New Patient Offer

Free Oral-B
Electric Toothbrush

Oral B Electric Toothbrush

Upon completion of New Patient Exam and X-rays

Simply complete the form below by the deadline to take advantage of this special offer.
This offer is limited to 1 free toothbrush per family.

Offer expires
05/26/2013

Parkville Dentist · John Huke, DDS · 6320 Lakecrest Lane · Parkville, MO · 64152