New Patient Form (Page 1 of 2)
New Patient Form (Page 2 of 2)
At Drs. Roger and Pamela Schmidt's office, we strive on providing the best customer service possible. Listed above are New Patient forms which can be filled out before you arrive at our office.
What Our Patients Say About Us
Dear Pam & Betsy (Roger too) and the whole staff, My most deepest appreciation for you guys! You're all the most caring professionals I've ever had the honor to work with. I can't believe my new smile! Thanks Kevin
Dear Roger, Thanks for the fantastic job you did on Gary's teeth! They are simply beautiful and you are such a talented dentist! We both feel really fortunate to have you in our community and caring for the both of us. All my best, Tina Dr. Roger & Pam, Just a quick note to tell you how wonderful you both are and what an amazing staff you have. I have to say I think you are both the best dentists we have in our area and I could never say enough about the staff you have. I also feel comfortable and well taken care of. There are countless numbers of smiles just entering your office. Everyone goes above and beyond to make you happy. I enjoy your updated equipment which lets me view everything your telling me about. I think it's just amazing. Myself and my family thank you again for everything!
Steve and Sherry
Hi everyone, I received many cards for my 50th birthday - one very special one from the people who help me with my very old teeth. Thanks so much - you made my day!
Sincerely, Louise
Dear Roger, I just wanted to tell you how impressed I am with you and your staff. Each time I come into your office, cheerful, friendly people greet me. Your staff is always helpful and they make me feel as if they have been waiting all day to see me. I have never heard an unkind word from any member of your staff directed to one another or to a patient. You definitely surround yourself with good quality people. The skill and expertise you show in your work has always amazed me. The bridgework you just put in my mouth feels as if it were a natural part of my mouth. The temporary bridge worked well but it felt awkward. Not uncomfortable, just rather plastic-like and foreign. The bridge apparatus you installed is so comfortable I don't realize it's in my mouth. The evening I had the bridge installed, I had dinner with our neighbors and I was able to enjoy all the best cooking of my neighbors (and they are good cooks). I don't hesitate to tell people about you. Anytime I hear of someone in need of a dentist or anytime I hear people grumble about their dentist or treatment they have received at their dentist's office, I am quick to tell them about you and your staff. You truly have a great thing going, Roger. Your hard work and effort has paid off. Thank you for your wonderful service and for hiring such good quality people. Sincerely, Tim Roger and Pam, Thanks again for my new crown! I love, love, love it!
Sincerely, Sue
Dear Drs. Roger, Pamela and staff- We feel we are truly blessed for having you as our dentists. I remember the first time I came to your office and you assured me that you two made a pact in dental school to make any treatment as painless as possible. We feel truly fortunate to have such wonderful dentists taking care of our family!
Fondly, Lee & Vel p.s. The surprise was delicious!
To Dr. Roger and your wonderful staff- Thanks ever so much for the TLC that I received from all of you - a warm blanket and hand muffs were so helpful in getting through a couple of heavy hours of work! And I wanted you to know that the gum around the left lower molar settled down within a week after! Thanks again to all of you.
Sandy
Dear Roger and Pam, I wanted to express my thanks to you and your entire staff for your continued excellent care of my mother's dental health. I appreciate the patience and professionalism we experience at every visit.
Sincerely, Ellen
Dear Pam and Roger, Just a note of congratulations for the twenty-five years of fine service you have given our family. Needless to say, we have enjoyed both the personal and professional association with you both. And we will continue to look forward to your good care. Thanks for the lovely, unique gift!
Wayne and Vivian
Dear Drs. Roger & Pamela Schmidt and Staff, This is just a short note to thank you for the wonderful surprise I received saturday morning. The box of chocolate covered strawberries came in wonderful shape and tasted even better. Your thoughtfulness goes even beyond the great service you have always given me throughout the many years I have been coming for your prevention-oriented dental service. Roger, it has been a privilege to have come to you in the early stages of your professional development and to see how Pamela and you have kept developing such a fine, competent practice, always looking for the best possible ways to serve your public. I have also appreciated your diligence in hiring and keeping such a fine, personable staff. You can count on my coming into Rockford for my semi-annual visits as long as either you are in practice or as long as my genereal health holds out. It's always a treat to come out of the city to drive past the farms and see how the corn grows and touch base with my own rural roots in northern Illinois.
Sincerely, Mason
Dr. Schmidt, Thank you for the tulips! What a wonderful, kind gesture on your part (not to mention very clever and trendy) - great idea! I have always appreciated your expert care, professionalism and your efforts to be cutting edge in the field of dentistry. I've referred several of your happy patients. I want to share when I find the best!
Thanks again. Carol
Dear Doctors Roger & Pamela Schmidt and Staff,
Thank you. I moved to Rockford on April 26, 1991 needing to find a new dentist for my family. Since there were three dentist offices near me, I wasn't sure which one to choose. During the summer of 1992, my late father-in-law came to visit and needed to see a dentist just for an observation. You were the only one available who would see him at no charge. On that day I made an appointment for my two boys and myself.
Thank you for:
- Being there the first time I needed you
- Accepting my family and me as your patients
- Allowing my boys to park their tricycles in your lobby area when we would walk to your office
- Caring for them and being a guardian when they became old enough to come without me when they were children
- Your continued care during their teen years
- Making each of their dental visits a pleasant one
- Allowing me to add a little "color" to your art gallery
My desire and prayer for you all is that the blessing of God be upon you and overtake you so that you will continue to be a blessing in this same manner to other mothers and their children.
Your grateful client, Sharon
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