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Feedback Assessment for Dental Services
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What kind of service was sought or has received from the College/Campus?
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When did you visit the Clinic?
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Who provided/suppose provider of the service
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Evaluators Information
Your Name? (Optional)
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Your Email? (Optional)
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Gender
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Age
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Course and Year (For current SSU students)
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Quality of Dental Service Delivery
How fast was your need delivered/accommodated?
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Did we fully serve your needs?
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Were you treated with courtesy and politeness?
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Are we competent and skilled enough? Are we knowledgeable on the service we provide?
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If service is provided in the clinic. How clean is the clinic?
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Situation of Clinic (lighting and ventilation)
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Grooming and neatness of Dental Personnel?
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Where you provided medicines?
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For special cases where clinic cannot provide, Have you been referred properly to other Doctors?
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(For previous patients) The Doctor provided follow-up services to me.
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OVERALL, how would you rate our services?
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Any additional comments you like to share with us? Please do not hesitate telling us. Your responses will be treated with utmost confidentiality.
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