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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?
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5
2. Were you greeted in a prompt and friendly manner?
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3. Was the dental hygienist professional and courteous?
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4. Was the dentist considerate and sensitive to your needs?
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5. How would you rate the cleanliness of the dental facility?
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6. Was your dental treatment completed to your satisfaction?
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7. Were the fees for your treatment explained to your satisfaction?
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8. How would you rate your overall experience?
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Please score yes or no.
9. Would you return to our dental practice for future work?
Yes
No
10. Would you refer a friend to our dental practice in the future?
Yes
No
Comments and/or Suggestions
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