Patient Satisfaction Survey
Exit this survey
1
. During a typical office visit, does your dentist spend too much time with you, too little time with you, or about the right amount of time with you?
During a typical office visit, does your dentist spend too much time with you, too little time with you, or about the right amount of time with you?
Much too much
Slightly too much
About the right amount
Slightly too little
Much too little
2
. How much do you trust your dentist to make medical decisions that are in your best interest?
How much do you trust your dentist to make medical decisions that are in your best interest?
A great deal
A lot
A moderate amount
A little
Not at all
3
. How well does your dentist listen to you?
How well does your dentist listen to you?
Extremely well
Very well
Moderately well
Slightly well
Not well at all
4
. How friendly is your dentist's office staff?
How friendly is your dentist's office staff?
Extremely friendly
Very friendly
Modreatley friendly
Slightly friendly
Not friendly at all
5
. How easy is it to book an appointment with your dentist?
How easy is it to book an appointment with your dentist?
Extremely easy
Very easy
Moderatley easy
Slightly easy
Not easy at all
6
. Over all, how satisfied are you with your visit to Riverside Dental?
Over all, how satisfied are you with your visit to Riverside Dental?
Extremely safisfied
Very satisfied
Neither satisfied or dissatisfied
Moderatley dissatisfied
Very dissatisfied
Extremely dissatisfied
7
. How likely are you to recommend your dentist to family or friends?
How likely are you to recommend your dentist to family or friends?
Extremely likely
Very likely
Moderatley likely
Slightly likely
Not at all likely
8
. How would you prefer to be contacted regarding your upcoming appointments?
How would you prefer to be contacted regarding your upcoming appointments?
Phone
Email
Text message
9
. Do you have any suggestions to make our office a more comfortable place to visit?
Do you have any suggestions to make our office a more comfortable place to visit?
10
. Do you have any further comments or suggestions for us?
*If you are happy with our services, we would love for you to leave a comment on our 'HOME' page to help potential patients get a better understanding of what they can look forward to. Thank you!
Do you have any further comments or suggestions for us? *If you are happy with our services, we would love for you to leave a comment on our 'HOME' page to help potential patients get a better understanding of what they can look forward to. Thank you!
Powered by
SurveyMonkey
Check out our
sample surveys
and create your own now!
Javascript is required for this site to function, please enable.