Survey
Name
First
Last
Email address
*
Before Your Surgery
1. Before your surgery, did anyone in this surgeon’s office give you easy to understand instructions about getting ready for your surgery?
*
Yes, definitely
Yes, somewhat
No
2. During your office visits before your surgery, did anyone in this surgeon’s office use pictures, drawings, models, or videos to help explain things to you?
*
Yes,
No
3. Did these pictures, drawings, models, or videos help you better understand your condition and its treatment?
*
Yes, definitely
Yes, somewhat
No
Your Surgery
4. Were you given something so you would not feel pain during your surgery?
*
Yes,
No
5. Did this surgery make you feel healthier in oral conditions?
*
Yes, definitely
Yes, somewhat
No
After Your Surgery
6. Did anyone in this surgeon’s office explain what to expect during your recovery period?
*
Yes, definitely
Yes, somewhat
No
7. Were you given something so you would not feel pain after your surgery?
*
Yes,
No
Your Overall Care From This Surgeon
6. Did anyone in this surgeon’s office explain what to expect during your recovery period?
*
0 Worst surgeon possible
1
2
3
4
5
6
7
8
9
10 Best surgeon possible
9. Social Media/ Photo Consent Form
Dr. Daniel Kao would like your permission to use this survey and images taken of you to showcase extraordinary before and after surgery on the website, Facebook pages and other social media.
*
Yes, definitely, please share my wonderful result.
No, I prefer not to share.
Send
This field should be left blank
Copyright © 2022 Daniel Kao. All Rights Reserved.