Foothill Dental Care Located at:
881 Fremont Avenue, Suite B-1
Los Altos, California 94024
Phone: 650-949-4734
Fax: 650-949-5710
Email: DrEzzati@foothilldental.com
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Questionnaire and Comments
If you've recently had an appointment with us, please help us make your visits more comfortable by filling out this questionnaire. To submit it electronically, please click the "Submit" button. You can also print this form, fill it out, and mail it to us.
  1. Do you have any comments about our reception area?

  2. Did our front office coordinator schedule your appointment properly and present your treatment plan in a professional way?

  3. Do you feel that our office operates smoothly?

  4. What was your experience with our dental assistants?

  5. Were you satisfied with the explanation the doctor gave you about your treatment?

  6. Please comment on the treatment the doctor gave you.

  7. Do you have any other comments about your visit?
The information provided in this form is for use by our office only.

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