The Fort Wayne Dentist Ueber & Friedrich Dentistry offers expert cosmetic dentistry, teeth whitening, and dental implants to Fort Wayne, IN.
The Cosmetic Dentist in Fort Wayne, IN uses porcelain veneers, tooth colored fillings and metal free crowns as cosmetic tools to create dazzling smile makeovers.
 
7215 Engle Road, Fort Wayne, Indiana 46804
 
(260) 434-1133
 
  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 :
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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.:


 
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New Patient Offer

Refer-a-Friend
Receive a $50.00 credit on your account when you
refer-a-friend to our practice. The person you refer will also receive a $50.00 credit on their account as well.

Simply complete the form below by the deadline.

Offer Expires:  08/05/2010


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Fort Wayne Dentist · Ueber & Friedrich Dentistry · 7215 Engle Road · Fort Wayne, IN · 46804 · (260) 434-1133