Patient Survey

When you telephoned to make an appointment, the staff members was courteous and helpful in finding a suitable time?
Consistently
Sometimes
Never
Upon arrival, were you greeted in a friendly manner and made to feel comfortable?
Consistently
Sometimes
Never
Were you seated by your appointment time or advised of any delays?
Consistently
Sometimes
Never
Did the dentist/hygienist take the time to listen to and understand your concerns?
Consistently
Sometimes
Never
Did the dentist/hygienist take the time to adequately explain the treatment plan and answer your questions?
Consistently
Sometimes
Never
Did you feel that you understood the prescribed treatment and all of your questions were answered to your satisfaction?
Consistently
Sometimes
Never
Upon receiving your bill for the services redeemed was the amount clearly described?
Consistently
Sometimes
Never
If you had a concern during your last visit, do you think it was properly handled by the staff?
Consistently
Sometimes
Never
During your last visit, did you feel that the staff was concerned about your overall well being as a person and not just your dental condition?
Consistently
Sometimes
Never
Are you comfortable with the level of technology used in the office?
Consistently
Sometimes
Never
Using the rating of 1 to 5, with 5 being the highest score how do you rate our office?
1 - (Lowest)
2
3
4
5 - (Highest)
Are you aware that we are accepting new patients?
Yes
No
Is there anything you would like to change about your smile?
Yes
No
Would you be interested in a free cosmetic consultation with the doctor?
Yes
No
Would you like to refer a friend or family member to our office?
Yes
No
We are always striving to improve our services. Your comments are important to us. How may we serve you better?
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