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PATIENT QUESTIONNAIRE

Patient Questionnaire

Help us to improve your dental practice!

Please answer the questions below to the best of your ability and satisfaction. Additional comments can be added at the end of the questionnaire.

We would like you to think about your recent experiences of our service.

Overall, how was your experience of our service?

Very PoorPoorNeither Good Nor PoorGoodVery Good

I was treated in a caring and respectful manner.

Strongly DisagreeDisagreeNeither agree or disagreeAgreeStrongly agree

I am able to contact the practice to make, change or cancel an appointment, whether by phone (voicemail), email or online.

Strongly DisagreeDisagreeNeither agree or disagreeAgreeStrongly agree

I am offered an appointment within a reasonable timeframe

Strongly DisagreeDisagreeNeither agree or disagreeAgreeStrongly agree

I am happy with the cleaniness and appearance of my practice.

Strongly DisagreeDisagreeNeither agree or disagreeAgreeStrongly agree

My treatment was properly explained along with alternative treatment options, risks and benefits if appropiate.

Strongly DisagreeDisagreeNeither agree or disagreeAgreeStrongly agree

The dental charges were explained to my satisfaction. (Please leave blank if not applicable).

Strongly DisagreeDisagreeNeither agree or disagreeAgreeStrongly agree

Which dental professional did you see?

Additional Comments / Messages for staff / What can we do to improve?

Your email address if you would like us to respond to you. We aim to respond to you within 48hrs.

Thanks for sharing! We always strive to improve.

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"To provide an ethical, caring and considerate dental service as part of an established Health Centre"

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