Treatment Review

Thank you so much for trusting us with your smile, we are over the moon that you are happy with your results and would appreciate if you could take a few minutes today to tell us about your experience?

If you prefer to send an email to us directly, rather than using the form below, please contact susan@mullangallagher.com

Treatment Review

Details

Your Name *

You Email *

Q1: What three words would you use to describe MGDC?

Q1: What three words would you use to describe MGDC?: Word 1

Word 1

Q1: What three words would you use to describe MGDC?: Word 2

Word 2

Q1: What three words would you use to describe MGDC?: Word 3

Word 3

Q2: Tell us why you originally chose to come to MGDC for your dental care?

Q3: What dental concern did you have that led you to seek treatment?

Q4: How did you find your experience? (Communication, staff, environment, clinical care)

Q5: What difference has having your treatment made for you?

Q6: What’s the one thing you’d say to someone considering having dental treatment at MGDC?

Q7: Is there anything we could do to improve your experience?

Permissions

It can be quite daunting to go from thinking about a new smile, to starting your journey (do you remember?!). With your story and gorgeous smile, we can show the wonderful possibilities ahead and give this confidence to others. We would never share anything you are not comfortable with, nor without your permission.

1

Permission 1

I give my permission to use my feedback in MGDC communications

If you would like your feedback to be anonymous please tick here

2

Permission 2

I give my permission to use the before and after pictures taken by the dentist

I prefer my dental pictures to remain anonymous

scroll down to examples of how this would appear

3

Permission 3

I am also happy to provide a before and after photograph of my choosing

I would prefer to provide an after photograph only

Image Upload

A picture is worth a thousand words. Scroll on down to see examples and please upload your photos here.

Maximum file size: 1MB

4

Permission 4

I am happy to be contacted by MDGC for a virtual video testimonial about my smile journey. This will be an informal chat via Zoom, recorded, edited and shared with me before use In MGDC communications

5

If you would like us to tag you when we use your quote / video / pictures, please add your social accounts below

This form collects your name, email address and phone number so our support team can communicate with you and provide assistance. Please check our Privacy Policy to see how we protect and manage your submitted data.

Consent Info *

I consent to having Mullan Gallagher Dental Care collect my details via this form.

If you are human, leave this field blank.