Patient Survey
 

Please take a moment to complete our survey.  Your comments are welcome and completely confidential. Your input will help us improve our service.  Thank you.

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 :
Date of your last visit:
How was the treatment you received :
How comfortable were you during the treatment you received :
Was your treatment explained to you so that you have a clear understanding of your dental situation :
Were your financial options explained to you? :
How long did you wait before being seated in a room?
Would you refer your friends and family to us? :
Please comment below on how we could make your next visit better and more comfortable.  Thank you.:


 
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New Patient Offer

Complimentary Welcome Exam
 (Regularly $264)

 In order to introduce you to the quality dental care we provide, we are extending a complimentary welcome exam to all of our new patients.
We want you to personally experience one-on-one care from Dr. Beaver and his team. You might even find yourself looking forward to visiting the dentist! Your new patient welcome exam includes: X-rays, dental exam and personal consultation with Dr. Beaver.

Does not include TMJ Migraine evaluation

OR

 $97
Whitening for Life!
 (Regularly $275)

We offer custom-fit whitening trays for a dazzling white smile. Then, as long as you keep current with your dental visits with us, you will receive additional gel as needed to maintain your bright, white smile. Patients must first receive a comprehensive new patient exam, teeth cleaning, and x-rays at regular prices.

Call us today or complete the form below.  Thank you.

New Patients Only. Restrictions may apply.


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Beaver Dental Care · 1677 Art Museum Drive · Jacksonville, FL · 32207 · (904) 396-4746
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