Rate our Services reg


Your opinions are important to us. We want to know how we are doing — the good and what we can do better. Please take a couple of minutes to provide us with important information to assist us in our efforts to better serve you. Your responses will be kept strictly confidential.


2. Consultation Date
3. How would you rate your Customer experience?
4. How would you rate your Dental experience?
5. Did the treatment make any difference?
6. Would you recommend this practice to your family and friends?
7. Please rate your interaction with our staff(where applicable)
1 – Inadequate 2 – Adequate 3 – Favorable 4 – Very Favorable 5 – Excellent
Dr Jurgens Grove Dr Marli Swanevelder Dr Martinette Engelbrecht Dr Liesl Jansen





Dr Esmari du Toit Dr Vlasta Peranovic Dr Francois le Roux Christa de Beer





Marteleen van Rooyen Louise Smith Linda Oelrich Lab Man





8. Optional
First name: Last Name:
Email: Phone:
May we contact you?
Best time to call :