Federal Way Dentist - Patient Survey

Federal Way Dentists, Dr. Mike Farley and Dr. David Mace provide gentle family general, cosmetic and restorative dental care in a friendly and comfortable environment in Federal Way.

1825 South 324th Place, Federal Way, WA 98003

(253) 838-2018
(253) 927-1056

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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 (optional):
E-mail Address (optional):
Date of your last visit (optional):
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 FREE Teeth Whitening
(In-home) Custom Trays with
New Patient Exam/Cleaning and Necessary X-rays.
(value of $325.00)
* Cannot be combined with other offers below

Refer-a-Friend
In appreciation of your referral, you will receive a $50.00 credit on your account and your friend will receive a $50.00 credit on their account!

Simply complete the form below by the deadline to take advantage of either of our special offers.

Offer Expires: 02/24/2012

<div style="text-align: center;"> 
New Patient Offer 
 
Receive FREE Teeth Whitening 
(In-home) Custom Trays with 
New Patient Exam/Cleaning and Necessary X-rays. 
(value of $325.00) 
* Cannot be combined with other offers below 
  
 
Refer-a-Friend 
In appreciation of your referral, you will receive a $50.00 credit on your account and your friend will receive a $50.00 credit on their account!    
 
Simply complete the form below by the deadline to take advantage of either of our special offers. 
</div>
<h3 style="color: red; text-align: center;"> 
 
Offer Expires: 02/24/2012</h3>

Please enter code above in the field below.

Federal Way Dentist Dr. Farley welcomes dental patients of all ages

Federal Way Dentist Dr. Farley welcomes you

Offer Expires: 02/24/2012

Federal Way Dentist · Precision Dental Care · 1825 South 324th Place · Federal Way, WA · Federal 98003