Patient Feedback Survey
Thank you for being a patient at The DENTAL Place!

We want to hear your feedback so we can keep improving our service. Please fill this quick survey and let us know your thoughts.

*This survey is required to enter in our 12th year anniversary giveaway*
Email address *
Name *
Phone Number *
Email *
How many visits have you made to our office in the past year? *
It was easy to make my first appointment *
Disagree
Agree
The front office was polite and helpful *
Disagree
Agree
I received a reminder of each of my appointments *
Disagree
Agree
It was easy to schedule a convenient appointment *
Disagree
Agree
Appointment options were given that suited my schedule *
Disagree
Agree
I was seen on time for my appointments *
Disagree
Agree
The area was neat and clean *
Disagree
Agree
The equipment was clean and presentable *
Disagree
Agree
The temperature in the office was comfortable *
Disagree
Agree
The lighting in the office was sufficient *
Disagree
Agree
The music in the office was pleasant *
Disagree
Agree
The dentist and dental assistant was professional and courteous *
Disagree
Agree
The dentist and dental assistant was considerate and sensitive to my needs *
Disagree
Agree
Other office personnel were courteous and helpful *
Disagree
Agree
My proposed dental treatment was clearly explained *
Disagree
Agree
Any questions I had were answered *
Disagree
Agree
I was given treatment alternatives *
Disagree
Agree
My dental treatment was completed efficiently and in a timely manner *
Disagree
Agree
I was pleased with the quality of my dental treatment *
Disagree
Agree
The dental treatment was completed to my satisfaction *
Disagree
Agree
The fees were explained prior to my treatment appointment *
Disagree
Agree
The fees for service were fair *
Disagree
Agree
I plan to remain a patient at this office *
Disagree
Agree
What I liked BEST about the office was:
What I liked LEAST about the office was:
In what way(s) could we have made your experience better?
Any additional comments?
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