top of page

PATIENT QUESTIONNAIRE

Patient Questionnaire

Help us to improve your dental practice!

Please answer the questions below to the best of your ability and satisfaction. Additional comments can be added at the end of the questionnaire.

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 UnlikelyUnlikelyNeither likely nor unlikelyLikelyExtremely likely
I am able to contact the practice to make, change or cancel an appointment (whether by phone or online).
Strongly DisagreeDisagreeNeither agree or disagreeAgreeStrongly agree
I am offered convenient appointment times.
Strongly DisagreeDisagreeNeither agree or disagreeAgreeStrongly agree
I was seen within a resonable time of my appointment.
Strongly DisagreeDisagreeNeither agree or disagreeAgreeStrongly agree
I am happy with the cleaniness and appearance of my practice.
Strongly DisagreeDisagreeNeither agree or disagreeAgreeStrongly agree
My treatment was properly explained along with alternative treatment options, risks and benefits if appropiate.
Strongly DisagreeDisagreeNeither agree or disagreeAgreeStrongly agree
The dental charges were explained to my satisfaction. (Please leave blank if not applicable).
Strongly DisagreeDisagreeNeither agree or disagreeAgreeStrongly agree

Thanks for sharing! We always strive to improve.

bottom of page