New Patient Registration
Patient Update Form
Pre-Appointment Survey
Post Appointment Survey

Post Appointment Survey

We appreciate you choosing our Smiles on Hudson and Dr. Gold, and we are committed to making sure that your time spent with us is as comfortable and fulfilling as possible. In order to continue providing the kind of care that keeps our patients smiling, we encourage your comments and suggestions about the treatments and personal care you've received while visiting our practice.

Please take a moment to provide us with your feedback. When you're finished, click on the SUBMIT button at the bottom of the page.

Please tell us about your appointment:

  • Contact Information: