Survey

We appreciate you taking the time to complete our survey. Please feel free to comment on your visit as well. Any comments you choose to leave will be kept strictly confidential and will only help us become better in the future!



Appointments

Strongly Agree


Agree


Neutral


Disagree


Strongly Disagree


Not Applicable


It was easy to make an appointment


















I was greeted warmly on arrival

 

 

 

 

 













My financial responsibility for today's treatment was explained to me

 

 

 

 

 

Facilities

Strongly Agree


Agree


Neutral


Disagree


Strongly Disagree


Not Applicable


The dental chair was clean and comfortable


















The equipment was clean and presentable

 

 

 

 

 













The reception area was neat & clean

 

 

 

 

 


Staff

Strongly Agree


Agree


Neutral


Disagree


Strongly Disagree


Not Applicable

The patient coordinator was professional, courteous and helpful on arrival






                       
The dentist was professional, courteous, respectful and helpful






                       
The dental hygienist was
professional, courteous, respectful and helpful

 

 

 

 

 













The dental assistant was professional, courteous, respectful and helpful

 

 

 

 

 













The  treatment coordinator was
professional, courteous, respectful and helpful

 

 

 

 

 


Treatment

Strongly Agree


Agree


Neutral


Disagree


Strongly Disagree


Not Applicable


All of my concerns were addressed today






                       
The provider's goals for today's treatment were clearly explained to me






                       
My goals for today's treatment were satisfied






                       
The treatment I received today was comfortable 

 

 

 

 

 













I am pleased with the
quality of dental treatment I received






                       
I am likely to refer my family and friends to this office




 



Treatment

Just Right


Too Much


A Little Too Much


A Bit Not Enough


Not Enough


Not Applicable

I feel the information I was given about my oral health was






                       
I feel the information I was given regarding home care suggestions was






                       
I feel the recommendations I was given for treatment were

 

 

 

 

 













I feel the treatment alternatives I was given were

 

 

 

 

 













Please leave a comment and tell us how we can improve!


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