Grammetry / PhotoG Feedback Form

Doctor Name
Patient Name
Case Number (e.g. CN123456)
Rate the Grammetry / PhotoG case overall

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5

1 is Worst, 5 is Best
Rate ROE's turnaround time

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5

1 is Worst, 5 is Best
Rate how the lab followed design instructions and photographs

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4

5

1 is Worst, 5 is Best
Rate how the prothesis seated

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4

5

1 is Worst, 5 is Best
Rate the bite

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5

1 is Worst, 5 is Best
Rate the midline

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5

1 is Worst, 5 is Best
Rate the prothesis thickness

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4

5

1 is Worst, 5 is Best
Rate the lab communication, if requested

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4

5

1 is Worst, 5 is Best
Please provide all relevant information
Would you like to speak to a senior member of the ROE team about this case
Phone Number
Format: (000) 000-0000.
Should be Empty: