Sherer Dental Lab

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How Did We Do?

Please take a moment to fill out our case survey. We utilize this information to improve our service to you and your patients. Your comments and suggestions are appreciated.

You can also print the form and mail it to us:

» Feedback Form (.pdf)

Please send form to:

Sherer Dental Lab
1145 Camden Avenue
Post Office Box 11627
Rock Hill, South Carolina 29731

Feedback Form

Doctor Name:
Patient Name:
REMOVABLE PROSTHETICS
Fit	Tight Good Loose
Occlusion	High Good Open
Esthetics	Excellent Good Poor
Instructions Followed?	Yes No
FIXED PROSTHETICS
Fit	Tight Good Loose
Shade	Dark Good Light
Occlusion	High Good Open
Contacts	Tight Good Open
Margins	Overextended Good Short-open
Esthetics	Excellent Good Poor
Instructions Followed?	Yes No
RELATIONS / CUSTOMER SERVICE
Received on Time?	Yes No
Instructions Followed?	Yes No
Require Major Adjustments?	Yes No
Approximate Time to Seat:
Invoiced Correctly?	Yes No
Notes

REMOVABLE PROSTHETICS

FIXED PROSTHETICS

RELATIONS / CUSTOMER SERVICE