Harborside Dental
General Dentistry & Cosmetic Dentistry
Traverse City, MI
231-946-0207
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    • Online Survey
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    • Fillings / Restorations
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    • Dentures
    • Bridges
    • Dental Implants
    • Crowns
    • Tooth Extractions
    • Non-Surgical Root Canal
    • Temporomandibular Disorder (TMD)
  • Cosmetic Treatments
    • Bonding
    • Porcelain Veneers
    • Inlays and Onlays
    • Teeth Whitening
    • Zoom!® Teeth Whitening
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    • Meet Dr. Kozelko
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Patient Information

  • Dental Patient Information
  • Patient Forms
  • First Visit
  • Scheduling
  • Financial Policy
  • Insurance
  • Infection Control
  • On-Site Full Service Lab
  • Advanced Dental Technology
  • Nitrous Oxide
  • Home Instructions
  • Smile Gallery
  • No Cavity Club
  • Privacy Practice Statement
  • Online Survey

Online Survey

Let us know how we are doing by filling out our secure online Patient Survey. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

  • Click here to complete our Online Survey!

Technical Note:

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 Adobe's web site. You Must OPEN the Adobe Reader Application after installation and make Adobe Reader your DEFAULT SAFARI PLUGIN for Viewing PDF Files.

PC Users

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

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Dr. Stephen Kozelko practices Family Dentistry & Cosmetic Dentistry at Harborside Dental in Traverse City MI, providing a full scope of dental care including
Dental Implant Restorations, Emergency Dental Care, Dentures, Full Mouth Reconstruction.
Address: 13300 South West Bay Shore Drive • Suite 1 • Traverse City, MI 49684 • Telephone: 231-946-0207 • Fax: 231-946-1004