Patient Satisfaction Survey Upon arriving at our dental practice: Full name Were you satisfied with our greeting? YesNo How would you rate the check-in process and wait time? —Please choose an option—ExcellentGoodUnsatisfactory How would you rate your comfort level during your appointment? —Please choose an option—ExcellentGoodUnsatisfactory Were your financial and dental options explained to you? YesNo How would you rate your Hygienist? —Please choose an option—ExcellentGoodUnsatisfactory How would you rate your Dentist? —Please choose an option—ExcellentGoodUnsatisfactory How likely are you to refer your friends and family to our dental office? —Please choose an option—Very likelyI could consider itNot very likely In which office were you treated? —Please choose an option—BellvilleTrenton Any additional comments you would like to share? Δ
