Orthodontist for Seattle, Southcenter, and Tukwila, WA (Washington): Orthodontist Brian Povolny
Meet Dr. Povolny
Meet the Team
Patient Information
Privacy Policy
All About Braces
FAQs
Care Kit
Emergency Care
Fun & Games
Contact Us
Home
COMMENT FORM

Comment Form»
Patient Referral Form »
Doctor Referral Form »

We enjoy having you as a patient and we are committed to making our relationship together as fulfilling as possible. In order to continue to serve happy patients, we would appreciate your suggestions and comments about our services.

Please fill out the form below and click the SUBMIT button to send us your comments. Because your comments are sent over the Internet, please do not include sensitive or personal information on this form.

1. Keeping in mind that quality orthodontics cannot be kept to a strict schedule, were you pleased with our scheduling system and the general flow of your appointment?

yes no

Comments:

2. Did you feel like our doctor(s) and team explained fully your treatment options, instructions, and questions?

yes no

Comments:

3. Did you feel like our team was ready and eager to assist you?

yes no

Comments:

4. Are there any areas in which our service could be improved?

yes no

Comments:

5. Our practice values happy, satisfied patients and our success is based on our patients’ recommendations. Would you refer your friends and family to us for their orthodontic needs?

yes no

Comments:

Verification Code (case sensitive):

Thank you for sharing your comments with us!



Back to Top
 


Dr. Brian Povolny, Orthodontist | 411 Strander Blvd. #104, Tukwila, WA 98188 | 206.575.1515

patient login | meet dr. povolny | meet the team | patient information | privacy policy
all about braces | faqs | care kit | emergency care | fun and games | contact us
site map | home | Orthodontic Web Site by Sesame Design™