Dental Satisfaction Survey
Your feedback is important to us. Please feel free to give us your comments.
Please rate your response from 1-5, 5 being highest.  
   
1. Was it easy to schedule an appointment?
2. Were you greeted in a prompt and friendly manner?
3. Was the dental hygienist professional and courteous?
4. Was the dentist considerate and sensitive to your needs?
5. How would you rate the cleanliness of the dental facility?
6. Was your dental treatment completed to your satisfaction?
7. Were the fees for your treatment explained to your satisfaction?
8. How would you rate your overall experience?
Please score yes or no.
9. Would you return to our dental practice for future work?
10. Would you refer a friend to our dental practice in the future?
Comments and/or Suggestions
 
Type the code from the image below