(203) 220-6610
160 Hawley Lane Suite 103
Trumbull, CT 06611
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Patient Survey

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

How would you rate your overall visit?
Excellent Very Good Average Not so good

When your appointment was over did you have a good understanding of your dental situation?
Yes Not really I wish I knew more about my situation

Were your financial options explained to you?
Yes No I already understand my financial options

Did you have to wait over 15 minutes past your appointment time to be seated? If so how long?
No 15 to 30 minutes 30 to 45 minutes Over 45 minutes

Did the staff greet you properly?
Yes Not really I don't recall

Would you refer your friends and family to us?
Yes No I'm not sure

Please comment on how we could make your visit better, new services you would like to see, or other ways we can make you feel more comfortable.


160 Hawley Lane, Suite 103, Trumbull, CT 06611 USA
Dr. Scott D. Cohen Trumbull Smiles in Trumbull, CT offers a wide range of dental services for their patients, from routine general dentistry examinations to more extensive procedures such as restorative and cosmetic dentistry. If you want to find out more about what Trumbull Smiles offers, please visit our services page or call us. Dr. Cohen and the rest of our team will work carefully with you to determine what the best course of action is to take. (203) 220-6610