Survey

Bonner and Schaible Dentists, Lebanon NJ

http://www.bonnerandschaible.com/

100%

Please take a few minutes to help us serve you better!

1. Your Name(Optional):

Your Name(Optional):

2. Was this your first visit to Bonner & Schaible?

Was this your first visit to Bonner & Schaible? Yes

Other (please specify)

3. How did you come to choose Bonner & Schaible as your Dentist?

How did you come to choose Bonner & Schaible as your Dentist? Referred by a friend

Has been my family dentist; someone in the family used them

Was in my insurance plan

Referred by a co-worker

Dissatisfied with my previous dentist

Web Site

Other (please specify)

4. Just thinking about your most recent office visit, how would you rate each of the following: very satisfied, satisfied, or dissatisfied?

	Very Satisfied	Satisfied	Dissatisfied	NA/DK
The general appearance of the office	*Just thinking about your most recent office visit, how would you rate each of the following: very satisfied, satisfied, or dissatisfied? The general appearance of the office Very Satisfied	The general appearance of the office Satisfied	The general appearance of the office Dissatisfied	The general appearance of the office NA/DK
Your ability to get an appointment when you wanted it	Your ability to get an appointment when you wanted it Very Satisfied	Your ability to get an appointment when you wanted it Satisfied	Your ability to get an appointment when you wanted it Dissatisfied	Your ability to get an appointment when you wanted it NA/DK
The courtesy of the office staff	The courtesy of the office staff Very Satisfied	The courtesy of the office staff Satisfied	The courtesy of the office staff Dissatisfied	The courtesy of the office staff NA/DK
Promptness of being treated upon your arrival	Promptness of being treated upon your arrival Very Satisfied	Promptness of being treated upon your arrival Satisfied	Promptness of being treated upon your arrival Dissatisfied	Promptness of being treated upon your arrival NA/DK
Quality of the treatment you received from the Dentist	Quality of the treatment you received from the Dentist Very Satisfied	Quality of the treatment you received from the Dentist Satisfied	Quality of the treatment you received from the Dentist Dissatisfied	Quality of the treatment you received from the Dentist NA/DK
Quality of the treatment you received from the Hygienist	Quality of the treatment you received from the Hygienist Very Satisfied	Quality of the treatment you received from the Hygienist Satisfied	Quality of the treatment you received from the Hygienist Dissatisfied	Quality of the treatment you received from the Hygienist NA/DK
Your Dentist's Professional attitude	Your Dentist's Professional attitude Very Satisfied	Your Dentist's Professional attitude Satisfied	Your Dentist's Professional attitude Dissatisfied	Your Dentist's Professional attitude NA/DK
Your Hygienist's Professional attitude	Your Hygienist's Professional attitude Very Satisfied	Your Hygienist's Professional attitude Satisfied	Your Hygienist's Professional attitude Dissatisfied	Your Hygienist's Professional attitude NA/DK
Follow-up you received after being treated at the office	Follow-up you received after being treated at the office Very Satisfied	Follow-up you received after being treated at the office Satisfied	Follow-up you received after being treated at the office Dissatisfied	Follow-up you received after being treated at the office NA/DK

5. Our Web Site and Newsletter(check all that apply to you):

Our Web Site and Newsletter(check all that apply to you): I read your Bonner & Schaible Newsletter and find it helpful.

I find the Bonner & Schaible Web Site helpful.

What I would like to see on your Web Site is

6. How would you describe Bonner & Schaible?

How would you describe Bonner & Schaible? Up-to-date and "ahead" of what's happening in dentistry

Average: neither "ahead" or "behind' what's latest in dentistry

I really do not know or cannot compare

Comment

7. Use a ten-point scale where 10 is Extremely Likely and 0 is Extremely Unlikely

	Extremely Unlikely									Extremely Likely
How likely would you be to recommend Bonner & Schaible to a friend or family member?	*Use a ten-point scale where 10 is Extremely Likely and 0 is Extremely Unlikely How likely would you be to recommend Bonner & Schaible to a friend or family member? Extremely Unlikely	How likely would you be to recommend Bonner & Schaible to a friend or family member?	How likely would you be to recommend Bonner & Schaible to a friend or family member?	How likely would you be to recommend Bonner & Schaible to a friend or family member?	How likely would you be to recommend Bonner & Schaible to a friend or family member?	How likely would you be to recommend Bonner & Schaible to a friend or family member?	How likely would you be to recommend Bonner & Schaible to a friend or family member?	How likely would you be to recommend Bonner & Schaible to a friend or family member?	How likely would you be to recommend Bonner & Schaible to a friend or family member?	How likely would you be to recommend Bonner & Schaible to a friend or family member? Extremely Likely

General Comments

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