Post-Appointment Survey

We appreciate you choosing our practice, and we are committed to making sure that your time spent with us is as comfortable and fulfilling as possible. In order to continue providing the kind of care that keeps our patients smiling, we encourage your comments and suggestions about the treatments and personal care you've received while visiting our practice.

Please take a moment to provide us with your feedback. When you're finished, click on the SUBMIT button at the bottom of the page.

Please tell us about your appointment:

Bold fields are required.

How would you rate your overall experience?


 
Contact Information:

Would you like a member of our team to contact you to further discuss your experience?

Please provide your name and email address:

 

Earn Patient Rewards

Ima­gine earn­ing points for be­ing a great pa­tient and hav­ing a great smile! With Lemke Orthodontics, you get to join a mem­ber­ship club of lucky users who earn points for do­ing all kinds of awe­some things. And the best part is that you get to use your points to play games, or­der gift cards and more!

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