Charleston WV Dentist

Charleston WV Dentist, Ghareeb Dental Group, four convenient locations: Poca, South Charleston, Cross Lanes, St. Albans

	WELCOME
	YOUR FIRST VISIT
	MEET THE DOCTORS
	SMILE GALLERY
	OUR SERVICES
	COSMETIC ANALYSIS
	ANXIETY-FREE DENTISTRY
	FINANCE OPTIONS
	HOURS & LOCATION
	APPOINTMENT REQUEST
	PATIENT SURVEY
	HELPFUL LINKS
	CONTACT US
	NEW VIDEO
	RAVE REVIEWS

Patient Survey

Please take a moment to complete our Patient 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 :
E-mail Address :
Date of your last visit:
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.

New Patient Offer

Receive $200 OFF Zoom Teeth Whitening!

ACT NOW to take advantage of this amazing offer by completing the form below.