Patient Survey First and Last Name: * Email Address: * When you telephoned to make an appointment, the staff member was courteous and helpful in finding a suitable time? YesSomewhatNoNot Applicable Upon arrival, were you greeted in a friendly manner and made to feel comfortable? YesSomewhatNoNot Applicable Were you seated by your appointment time or advised of any delays? YesSomewhatNoNot Applicable Did the dentist/hygienist take the time to listen to and understand your concerns? YesSomewhatNoNot Applicable Did you feel that you understood the prescribed treatment and all your questions were answered to your satisfaction? YesSomewhatNoNot Applicable Upon receiving your bill for the services redeemed was the amount clearly described? YesSomewhatNoNot Applicable Upon receiving your bill for the services redeemed were payment options discussed? YesSomewhatNoNot Applicable If you had a concern during your last visit, do you think it was properly handled by the staff? YesSomewhatNoNot Applicable During your last visit, did you feel that the staff was concerned about your overall well being as a person and not just your dental condition? YesSomewhatNoNot Applicable Are you comfortable with the level of technology used in the office? YesSomewhatNoNot Applicable How did you hear about us? Please SelectLocal Flyers DistributionBus Shelter AdvertisementDentistry on Dusk External Building SignageGoogle AdsGoogle Search EngineFacebook pageNo Frills SignageAdvertising inside Divine Spa / Dusk Physiotherapy / Dusk Medical CentreExisting patient of Dentistry on Dusk Using the rating of 1 to 5, with 5 being the highest score how do you rate our office? Please Select12345 Suggestions for Improvement: We are always striving to improve our services. Your comments are important to us. How may we serve you better?