Practice Survey

Practice Survey

Divider

Did we make you smile?
We are committed to the continual improvement in the care we give our patients. Your response to the following questions will let us know how we can serve all our patients better. Check the number that most accurately represents your response.

Divider

Upon arrival I was greeted courteously.
Needs Improvement  1 2 3 4 5 Exceptional

I was seated by my appointment time or advised of any delays.
Needs Improvement  1 2 3 4 5 Exceptional

I felt the doctor and team listened and understood my dental concerns.
Needs Improvement  1 2 3 4 5 Exceptional

I felt that everyone was concerned about my total wellbeing as a person, not just my dental needs.
Needs Improvement  1 2 3 4 5 Exceptional

I feel I understand the treatment prescribed and all of my questions were answered to my satisfaction.
Needs Improvement  1 2 3 4 5 Exceptional

Payment options were discussed and financial arrangements made for all treatments.
Needs Improvement  1 2 3 4 5 Exceptional

Please rate the overall courtesy and friendliness of the doctor and the dental team.
Needs Improvement  1 2 3 4 5 Exceptional

Please rate your overall comfort level in the office.
Needs Improvement  1 2 3 4 5 Exceptional

The reception area, restroom and treatment rooms are clean and comfortable.
Needs Improvement  1 2 3 4 5 Exceptional

I look forward to recommending this office to family and friends.
Needs Improvement  1 2 3 4 5 Exceptional

Are there any team members you would like to recognize for outstanding care or service?

Additional Comments

Name

Email

Enter Text Below
captcha

Divider
Bookmark and Share



Copyright Mogelof Dental Group Cosmetic Dentistry | Powered by Netwirks