PATIENT SATISFACTORY SURVEY

In order to provide you with the best dental services possible, we want to know how well we are doing now and what we might do better from your point of view. Please take a couple of minutes to provide us with important information to assist us in our effort to better serve you.

 

Grade us by checking either A, B, C or D after each question.

A= Excellent, B= Very Favorable, C= Favorable, D= Inadequate

 

 

Thank you for completing this survey; we appreciate your thoughts and suggestions on how we can make your visit with us more comfortable, convenient, and pleasant. 

 

1. How easy was it to make an appointment? A B C D 2. Were the forms you filled out or information required easy to understand? A B C D 3. Was parking convenient and adequate? A B C D 4. Was the reception area comfortable and welcoming? A B C D 5. Was the receptionist pleasant and helpful? A B C D 6. Did you find the treatment area pleasant and non-threatening? A B C D 7. What degree of trust do you have in Dr. Fernandez? A B C D 8. Did the dental care providers treat you as you wanted to be treated? A B C D 9. Were your fears about dental care discussed to your satisfaction? A B C D 10. How do you rate the cleanliness, appearance and comfort of the office? A B C D 11. Does the business operation of the office handle your account properly? A B C D 12. Would you recommend our Practice to your friends and family? A B C D Comments: