Patient Satisfaction Survey

Our goal is to insure that your experience is as atraumatic and pleasant as possible. We would greatly appreciate any feedback, negative or positive, about your visit, so we may improve our performance in the future.

You can fill out and submit the form online or print it and send it to:

Washington OMS
P.O. Box 13330
Everett, WA 98201

To download patient satisfaction form, click here.

Technical Note:

PC Users
Our online form uses the latest version of Adobe Acrobat Reader to conveniently submit the form from home or work. Please download the free plug-in from Adobes web site if it is not already installed on your system. It is important that you have at least version 9 of the plug-in to successfully use our online form.

Mac Users
You must open and submit the form in a Safari Browser with the latest Mac operating system. It is also important to have the latest version of Adobe Acrobat Reader on your computer in order to submit your form to our office correctly, please download the free plug-in from Adobes web site.