COMMUNICATION IS THE KEY!
2317 Sunset Boulevard
West Columbia, SC 29169
803.939.0360
803.939.0363 Fax
888.228.2131 Toll Free

Technical Questions?
Billing/Fee Questions?
General Inquiries? Comments?
Feedback about the products and service we provide is vital to preventing any possible future problems, should they arise. Then again, it's nice to know sometimes if a patient was particularly happy with the outcome of their denture. Good or not-so-good, we always love to hear from you!
CASE FEEDBACK FORM
*Doctor
*Patient
*Restoration
*E-mail
email me
Partial Frameworks
1. Frame Design
2. Occlusion
3. Clasp Adaptation
4. Retention
5. Clasp Contour
6. Overall Finish
Full Dentures
1. Tooth Arrangment
2. Occlusion
3. Peripheral Borders
4. Post Dam
5. Festooning
6. Retention
Chair Time
Case on Time?
Additional Comments
GoodToo Many ClaspsNot Enough Clasps
GoodHighLow
GoodTightLoose
GoodTightLoose
GoodToo ThinToo Bulky
GoodAveragePoor
GoodOver CharacterizedUnder Characterized
GoodHighLow
GoodThinOver Extended
GoodLightHeavy
GoodLightHeavy
GoodTight Loose
ThickUnder Extended
MinimalAverageExcessive
YesNoNeeds Improvement