Patient Satisfaction Survey

YOUR OPINION COUNTS! We want to know how you feel about our services because we want to ensure we are meeting your needs. Your responses to the areas listed below will have a direct impact on improving our practice. Please know all responses will be kept confidential and anonymous. Thank you for your time.

Facility
	Great	Good	OK	Fair	Poor
Access to building
Ease of finding where to go within the practice
General cleanliness of building
Comfort and safety while waiting

Staff
Listens to what you are saying
Takes enough time with you
Provides an explanation to what you want to know
Gives you good treatment
Friendly and helpful
Answers your questions

Ease & Convenience Getting Care
Hours dental office is open
Ability to get in to be seen
Time in waiting area
Time waiting in dental chair

Payment
What you pay is reasonable
Explanation of charges is provided
Financial options are presented

Confidentiality
Keeping my personal information private
Privacy when discussing financial issues
The likelihood of referring your friends and relatives to us.

Do you consider this practice your regular source of dental care?

What do you like best about our practice?

What do you like least about our dental practice?

Suggestions for improvement