Feedback
We want to make your opinion count. Please give us as much information as possible when contacting us so we can be as accurate as possible in our reply.
Patient Name:
Telephone Number (optional):
Name of your dentist:
General
On your visit how clean was the practice
Excellent
Average
Poor
What's your opinion on the standard of decor
Excellent
Average
Poor
Were the reception staff dressed neatly and in uniform
Excellent
Average
Poor
How friendly was your welcome on arrival
Excellent
Average
Poor
Was your appointment confirmed and particulars checked
Yes
No
Were you directed to the appropriate waiting area
Yes
No
Were you informed by reception of any possible delays in appointment times
(e.g. over run by clinician)
Yes
No
Was the waiting area neat and tidy
Yes
No
Clinical Care
Was the surgery neat & tidy
Yes
No
Were clinical staff in uniform
Yes
No
Was the clinician wearing a name badge
Yes
No
If appropriate were you offered alternative treatments:
White fillings instead of metal
Yes
No
Implants instead of dentures
Yes
No
Bridgework instead of dentures
Yes
No
White crown (caps) instead of metal
Yes
No
Root fillings instead of extraction
Yes
No
Cosmetic treatment e.g. veneers, tooth whitening
Yes
No
Were you provided with a treatment quotation
Yes
No
Was the proposed treatment fully explained to you
Yes
No
Were you informed of easy payment plans (e.g. Denplan or Private Care Plan)
Yes
No
Were you kept waiting prior to your appointment time
Yes
No
Did the clinician run on time
Yes
No
How satisfied were you with the treatment you received
Excellent
Average
Poor
Did you receive value for money
Yes
No
Would you recommend us to your friends
Yes
No
Please give further details to any of the above questions:
Any further suggestions you wish to add to improve this practice:
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