Our Practice

New Patient
Patient Survey

Your experience with our Dentist (Step 1 of 3)



1.Do you feel that the dentist listened well to your particular requirements and/or concerns?
  Excellent   Very good   Good   Average   Poor
2. Were you given adequate time to consider your treatment?
  Excellent   Very good   Good   Average   Poor
3. Were your options communicated well to you by your dentist?
  Excellent   Very good   Good   Average   Poor
4. Were you requested to sign a treatment plan, which clearly outlined details of your proposed treatment and any costs involved?
  Excellent   Very good   Good   Average   Poor
5. Would you recommend your dentist to your friends and family?
  Excellent   Very good   Good   Average   Poor
Please add any further comments below is missing:

Your experience with our Receptionist (Step 1 of 3)



6. How easy was it to obtain an appointment?
  Excellent   Very good   Good   Average   Poor
7. Did you find the premises and facilities to your needs?
  Excellent   Very good   Good   Average   Poor
8.Was your patient confidentiality respected?
  Excellent   Very good   Good   Average   Poor
9. Are you satisfied with the way in which you have been treated, either face to face or over the phone?
  Excellent   Very good   Good   Average   Poor
10. We would like you to think about your recent experiences of our service. How likely are you to recommend our dental practice to friends and family if they needed similar care or treatment?
  Extremely Likely   Likely   Neither likely or unlikely   Unlikely   Extremely Unlikely   Don't Know
Please add any further comments below is missing :
 
Name :
 
Email :
 
Phone :
 

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