Dr. Ryan Thomas Dentistry Client Feedback Survey
This information is being used to guide positive changes and reinforce existing strengths so please respond openly and honestly. All feedback is welcome. Try not to overthink your answers, go with your first instinct.
The survey should take approximately 5 minutes to complete. It is comprised of rating scale questions and open ended response questions. Each question requires a response, so if the survey does not allow you to proceed you will be prompted to go back and answer fully before moving to the next section.
* Required
1. Evaluate the following statements
The quality of the service was exceptional.
*
Strongly Agree
Agree
Neither Disagree or Agree
Disagree
Strongly Disagree
I was treated with great care and respect.
*
Strongly Agree
Agree
Neither Disagree or Agree
Disagree
Strongly Disagree
The team made me feel welcome and safe.
*
Strongly Agree
Agree
Neither Disagree or Agree
Disagree
Strongly Disagree
The team clearly communicated all key information about my appointment and treatment.
*
Strongly Agree
Agree
Neither Disagree or Agree
Disagree
Strongly Disagree
The team took the time to properly answer all of my questions and address my concerns.
*
Strongly Agree
Agree
Neither Disagree or Agree
Disagree
Strongly Disagree
Provide additional comments if you wish
Your answer
2. Please rate how well we are doing for each of the following statements
We properly welcome our patients when they enter the practice.
*
Strongly Agree
Agree
Neither Disagree or Agree
Disagree
Strongly Disagree
We have created a warm and comfortable waiting area.
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Strongly Agree
Agree
Neither Disagree or Agree
Disagree
Strongly Disagree
We have gone out of our way to ensure you've had a good experience at our practice.
*
Strongly Agree
Agree
Neither Disagree or Agree
Disagree
Strongly Disagree
Provide additional comments if you wish.
Your answer
3. Please rate how we are doing on the following
Positive
*
Strongly Agree
Agree
Neither Disagree or Agree
Disagree
Strongly Disagree
Friendly and Welcoming
*
Strongly Agree
Agree
Neither Disagree or Agree
Disagree
Strongly Disagree
Open and Honest
*
Strongly Agree
Agree
Neither Disagree or Agree
Disagree
Strongly Disagree
Professional
*
Strongly Agree
Agree
Neither Disagree or Agree
Disagree
Strongly Disagree
On Time / Timely
*
Strongly Agree
Agree
Neither Disagree or Agree
Disagree
Strongly Disagree
Provide additional comments if you wish.
Your answer
Recommending Dr. Ryan Thomas Dentistry
How likely is it that you would recommend Dr. Ryan Thomas Dentistry to a friend or colleague?
*
Highly Unlikely
1
2
3
4
5
6
7
8
9
10
Extremely Likely
What is the primary reason for the score you just gave?
*
Your answer
What is the most important improvement you'd like to see that will make Dr. Ryan Thomas Dentistry better in the future?
*
Your answer
What additional comments or suggestions do you have for us at this time?
*
Your answer
If asked, are you willing to provide a testimonial for the practice?
*
Yes
No
Name
Your answer
e-mail
Your answer
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