Anchorage Dentist - Patient Survey

Anchorage Dentist, Dr. Richard Williams and Dr. Brett Gardiner, provides reliable, results-oriented cosmetic, family and restorative dentistry in a comfortable environment in Anchorage.

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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 :
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.

Care Enough to Share Referral Program.
Receive a $50. Gift Card for each NEW patient referral.

Special New Patient Package Offer for $199.

(Valued between $350.00 and $450.00 in other offices around town)
Includes complete dental exam and consultation,
cleaning and polishing and necessary x-rays,
plus a complimentary take-home teeth whitening option upon request.

Simply complete the form below and we will contact you soon.

Anchorage Dentist · Williams Dental Care · 4000 Old Seward Hwy Ste #100 · Anchorage, AK · 99503

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