Patient feedback

How did you hear about us? (required)

Current patient recommendationMagazineLocalInternetReferral, from dentistOther, please specify

How did you book your appointment? (required)
EmailIn personOnlinePhone

What is your preferred method of contact in respect of appointment reminders and recalls? (required)
MobileEmailPost

Appointments

Was it easy to obtain your preferred appointment time? (required)
YesNo

Was the appointment coordinator polite and helpful? (required)
YesNo

I had a good understanding what my appointment will involve (required)
YesNo

I was seen on time for my appointment, if not I was given a reason for the delay (required)
YesNo

Any Comments?

Facilities

What did you think of the overall appearance and cleanliness of the practice? (required)

Practice Personal: Dentists

Are the dentist helpful? (required)
YesNo

Caring? (required)
YesNo

Friendly? (required)
YesNo

Do they listen to you? (required)
YesNo

Do they explain enough to you? (required)
YesNo

Do you feel confident about the quality of treatment they are providing for you? (required)
YesNo

Practice Personal - Other staff (reception/hygiene/dental nurse/practice manager)

Are they friendly? (required)
YesNo

Caring? (required)
YesNo

Helpful? (required)
YesNo

Are they well informed? (required)
YesNo

Do they reassure you? (required)
YesNo

Patient Information

Are there enough useful dental leaflets? (required)
YesNo

Is our website user friendly? (required)

YesNo

Were you given a treatment plan? (required)
YesNo

Were you given finance options? (required)
YesNo

Any Comments?