Shine Orthodontics Survey NEW PATIENT CONSULTATION VIRTUAL CONSULTATION DENTIST REFERRAL 1. Name: * 2. How did you hear about us? 3. What specifically drew you into pursuing treatment with Dr. Scheer? 4. Is there anything Dr. Scheer could have done differently to heighten your treatment experience? 5. Did Dr. Scheer answer any and all questions you might have had during treatment? 6. How was your experience with any other staff you interacted with? 7. How likely are you to recommend our practice to friends and family? 8. Is there anything you think our office overall should change? 9. Is there anything else we should know? 10. We Would really appreciate it if you could also leave us a review on Google! Thank you in advance.