Comment Form

"We make you want to smile!"

…at least we hope we do. Please help us to meet that goal, by sharing your suggestions and comments regarding our practice.

Please fill out the form below and click the SUBMIT button. Because your comments are sent over the Internet, please do not include sensitive or personal information on this form.

1. Are you pleased with how you and/or your family were treated at Pickard Orthodontics?

YES NO

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2. Did Dr. Pickard and his team explain fully your treatment options and fees for any proposed treatment, provide adequate instructions, and/or answer your questions?

YES NO

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3. Did you feel like our team was ready and eager to assist you?

YES NO

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4. Are there any areas in which our service could be improved?

YES NO

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5. The success of our practice is built on satisfied patients and their families, who recommend us to others who might benefit from our services. Can we count on you to refer your friends, neighbors and family to us for their orthodontic needs?

YES NO

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Thank you for sharing your comments with us!