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Post-Appointment Survey

We appreciate you choosing our practice, and we are committed to making sure that your time spent with us is as comfortable and fulfilling as possible. In order to continue providing the kind of care that keeps our patients smiling, we encourage your comments and suggestions about the treatments and personal care you’ve received while visiting our practice.

Please take a moment to provide us with your feedback. When you’re finished, click on the SUBMITbutton at the bottom of the page

Please Tell Us About Your Appointment:

How would you rate your overall experience?

Contact Information:
Please provide your name and phone number:


I give my permission for Lalor Family Dental to share the feedback I have provided with other current and prospective patients.


Would you like a member of our team to contact you to further discuss your experience?

Please provide your name and phone number:

Preferred method of contact? (Please be sure to fill out the necessary contact fields)