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Patient Survey
First and Last Name:
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Email Address:
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When you telephoned to make an appointment, the staff member was courteous and helpful in finding a suitable time?
Yes
Somewhat
No
Not Applicable
Upon arrival, were you greeted in a friendly manner and made to feel comfortable?
Yes
Somewhat
No
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Were you seated by your appointment time or advised of any delays?
Yes
Somewhat
No
Not Applicable
Did the dentist/hygienist take the time to listen to and understand your concerns?
Yes
Somewhat
No
Not Applicable
Did you feel that you understood the prescribed treatment and all your questions were answered to your satisfaction?
Yes
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No
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Upon receiving your bill for the services redeemed was the amount clearly described?
Yes
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No
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Upon receiving your bill for the services redeemed were payment options discussed?
Yes
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No
Not Applicable
If you had a concern during your last visit, do you think it was properly handled by the staff?
Yes
Somewhat
No
Not 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?
Yes
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No
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Are you comfortable with the level of technology used in the office?
Yes
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How did you hear about us?
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Existing patient of Dentistry on Dusk
Using the rating of 1 to 5, with 5 being the highest score how do you rate our office?
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Suggestions for Improvement:
We are always striving to improve our services. Your comments are important to us. How may we serve you better?
Our Services
Family Dentistry
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White Fillings in Brampton
Pediatric Dentistry
Prevention Tips
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Home Care and Brushing
Sports Mouth Guards
Dental Night Guard, Brampton
Oral Cancer Screening
Gum Therapy
How to Brush Your Teeth
Emergency Dental Care
Tooth Extractions
Root Canal Therapy
Trauma Management
Toothache
Canker/Cold sore
Repair of Fractured Teeth
Sensitive Teeth
Orthodontics and Invisalign
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Get High-Quality Dentures from Brampton’s Best Dentistry Clinic
How are Dentures Made?
Getting Used to your Denture
Care for your Denture
Denture Adjustment (How to Get a More Beautiful Smile)
Care for your Denture
Common Concerns for Dentures
Denture Adhesives
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