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Date
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Name
First
Last
Email
*
Type of Procedure
*
Examination
Scaling and Root Planing (Deep Cleaning)
Osseous Surgery (Gum Disease Surgery)
Gingival Graft (Gum Graft)
Esthetic Crown Lengthening
Bone Graft for Implants
Dental Implant Surgery
How traumatic was the procedure?
*
Less traumatic than I expected
More traumatic than I expected
About what I expected
How many days off work did you take?
*
None
1 Day
2 Days
3 Days
4 Days
The doctor and staff made me feel comfortable and at ease:
*
Yes
No
Overall rating of my visits at the office of Dr. Benjamin Tingey:
*
1 Star
2 Stars
3 Stars
4 Stars
5 Stars
Comments
8400 Osuna Rd NE, Suite 1A Albuquerque, NM 87111
(505) 275-0500
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