{"id":1477,"date":"2020-08-13T14:30:57","date_gmt":"2020-08-13T14:30:57","guid":{"rendered":"https:\/\/nockdentalgroup.com\/?page_id=1477"},"modified":"2020-08-13T14:32:01","modified_gmt":"2020-08-13T14:32:01","slug":"post-appointment-survey","status":"publish","type":"page","link":"https:\/\/nockdentalgroup.com\/post-appointment-survey\/","title":{"rendered":"Post-Appointment Survey"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1477\" class=\"elementor elementor-1477\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<div class=\"elementor-inner\">\n\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3a3c51c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3a3c51c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1e6c669\" data-id=\"1e6c669\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3360739 elementor-widget elementor-widget-text-editor\" data-id=\"3360739\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-text-editor elementor-clearfix\">\n\t\t\t\t<p class=\"width2\">We appreciate you choosing our practice, and we are committed to making sure that your time spent with us is as comfortable and fulfilling as possible. In order to continue providing the kind of care that keeps our patients smiling, we encourage your comments and suggestions about the treatments and personal care you&#8217;ve received while visiting our practice.<\/p><p class=\"width2\">Please take a moment to provide us with your feedback. When you&#8217;re finished, click on the\u00a0<strong>SUBMIT<\/strong>\u00a0button at the bottom of the page.<\/p><form class=\"width2 validate\" action=\"http:\/\/www.nockdentalgroup.com\/post-appointment-survey\" method=\"post\"><label for=\"Web_Address\"><\/label><fieldset><legend>Please tell us about your appointment:<\/legend><\/fieldset><\/form>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9798156 eael-gravity-form-button-custom elementor-widget elementor-widget-eael-gravity-form\" data-id=\"9798156\" data-element_type=\"widget\" data-widget_type=\"eael-gravity-form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t            <div class=\"eael-contact-form eael-gravity-form eael-contact-form-align-default\">\n                                <script type=\"text\/javascript\">var 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               <div class='gform-body gform_body'><ul id='gform_fields_3' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_3_1\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_1\"><label class='gfield_label gform-field-label' for='input_3_1' >Please describe your experience visiting our practice.<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_1' id='input_3_1' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_3_2\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_2\"><label class='gfield_label gform-field-label' for='input_3_2' >Please describe your experience working with the doctor(s) and staff.<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_2' id='input_3_2' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_3_3\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_3\"><label class='gfield_label gform-field-label' for='input_3_3' >What was your favorite thing about being at our practice?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_3' id='input_3_3' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_3_4\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_4\"><label class='gfield_label gform-field-label' for='input_3_4' >What areas could we improve upon to make your experience even more enjoyable?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_4' id='input_3_4' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_3_5\"  class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_5\"><label class='gfield_label gform-field-label'  >How would you rate your overall experience?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_3_5'>\n\t\t\t<li class='gchoice gchoice_3_5_0'>\n\t\t\t\t<input name='input_5' type='radio' value='Poor'  id='choice_3_5_0'    \/>\n\t\t\t\t<label for='choice_3_5_0' id='label_3_5_0' class='gform-field-label gform-field-label--type-inline'>Poor<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_3_5_1'>\n\t\t\t\t<input name='input_5' type='radio' value='Average'  id='choice_3_5_1'    \/>\n\t\t\t\t<label for='choice_3_5_1' id='label_3_5_1' class='gform-field-label gform-field-label--type-inline'>Average<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_3_5_2'>\n\t\t\t\t<input name='input_5' type='radio' value='Good'  id='choice_3_5_2'    \/>\n\t\t\t\t<label for='choice_3_5_2' id='label_3_5_2' class='gform-field-label gform-field-label--type-inline'>Good<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_3_5_3'>\n\t\t\t\t<input name='input_5' type='radio' value='Great!'  id='choice_3_5_3'    \/>\n\t\t\t\t<label for='choice_3_5_3' id='label_3_5_3' class='gform-field-label gform-field-label--type-inline'>Great!<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_3_7\"  class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_3_7\"><label class='gfield_label gform-field-label' for='input_3_7' >Would you like a member of our team to 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