Hammond Customer Satisfaction Survey

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1. Which dental care provider did you see during your last visit?

Which dental care provider did you see during your last visit? Dr. Hope Taylor

Dr. Danny Gerstner

Dr William O'Brien, Periodontist

Connie Silvey, Registered Dental Hygienist

Brandi Doussan, Registered Dental Hygienist

Staci Miller, Registered Dental Hygienist

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2. Please choose the response that best reflects your answer based on the rating scale below:
1 = Always
2 = Usually
3 = Sometimes
4 = Rarely
5 = Never
6 = N/A

	Always	Usually	Sometimes	Rarely	Never	N/A
1. Is it easy to make an appointment?	*Please choose the response that best reflects your answer based on the rating scale below: 1 = Always 2 = Usually 3 = Sometimes 4 = Rarely 5 = Never 6 = N/A 1. Is it easy to make an appointment? Always	1. Is it easy to make an appointment? Usually	1. Is it easy to make an appointment? Sometimes	1. Is it easy to make an appointment? Rarely	1. Is it easy to make an appointment? Never	1. Is it easy to make an appointment? N/A
2. Do we answer the phone promptly and politely?	2. Do we answer the phone promptly and politely? Always	2. Do we answer the phone promptly and politely? Usually	2. Do we answer the phone promptly and politely? Sometimes	2. Do we answer the phone promptly and politely? Rarely	2. Do we answer the phone promptly and politely? Never	2. Do we answer the phone promptly and politely? N/A
3. If you were put on hold did our staff return to you in a reasonable amount of time?	3. If you were put on hold did our staff return to you in a reasonable amount of time? Always	3. If you were put on hold did our staff return to you in a reasonable amount of time? Usually	3. If you were put on hold did our staff return to you in a reasonable amount of time? Sometimes	3. If you were put on hold did our staff return to you in a reasonable amount of time? Rarely	3. If you were put on hold did our staff return to you in a reasonable amount of time? Never	3. If you were put on hold did our staff return to you in a reasonable amount of time? N/A
4. Were you satisfied with the amount of time from your call to your appointment date?	4. Were you satisfied with the amount of time from your call to your appointment date? Always	4. Were you satisfied with the amount of time from your call to your appointment date? Usually	4. Were you satisfied with the amount of time from your call to your appointment date? Sometimes	4. Were you satisfied with the amount of time from your call to your appointment date? Rarely	4. Were you satisfied with the amount of time from your call to your appointment date? Never	4. Were you satisfied with the amount of time from your call to your appointment date? N/A
5. Were you greeted pleasantly upon arrival for your appointment?	5. Were you greeted pleasantly upon arrival for your appointment? Always	5. Were you greeted pleasantly upon arrival for your appointment? Usually	5. Were you greeted pleasantly upon arrival for your appointment? Sometimes	5. Were you greeted pleasantly upon arrival for your appointment? Rarely	5. Were you greeted pleasantly upon arrival for your appointment? Never	5. Were you greeted pleasantly upon arrival for your appointment? N/A
6. Is our reception area clean and comfortable?	6. Is our reception area clean and comfortable? Always	6. Is our reception area clean and comfortable? Usually	6. Is our reception area clean and comfortable? Sometimes	6. Is our reception area clean and comfortable? Rarely	6. Is our reception area clean and comfortable? Never	6. Is our reception area clean and comfortable? N/A
7. Did we see you on time for your appointment?	7. Did we see you on time for your appointment? Always	7. Did we see you on time for your appointment? Usually	7. Did we see you on time for your appointment? Sometimes	7. Did we see you on time for your appointment? Rarely	7. Did we see you on time for your appointment? Never	7. Did we see you on time for your appointment? N/A
8. Does our staff seem genuinely interested in you?	8. Does our staff seem genuinely interested in you? Always	8. Does our staff seem genuinely interested in you? Usually	8. Does our staff seem genuinely interested in you? Sometimes	8. Does our staff seem genuinely interested in you? Rarely	8. Does our staff seem genuinely interested in you? Never	8. Does our staff seem genuinely interested in you? N/A
9. Were our examination rooms clean and comfortable?	9. Were our examination rooms clean and comfortable? Always	9. Were our examination rooms clean and comfortable? Usually	9. Were our examination rooms clean and comfortable? Sometimes	9. Were our examination rooms clean and comfortable? Rarely	9. Were our examination rooms clean and comfortable? Never	9. Were our examination rooms clean and comfortable? N/A
10. Did our clinical staff treat you with compassion and respect?	10. Did our clinical staff treat you with compassion and respect? Always	10. Did our clinical staff treat you with compassion and respect? Usually	10. Did our clinical staff treat you with compassion and respect? Sometimes	10. Did our clinical staff treat you with compassion and respect? Rarely	10. Did our clinical staff treat you with compassion and respect? Never	10. Did our clinical staff treat you with compassion and respect? N/A
11. Did our clinical staff explain the treatment to you sufficiently?	11. Did our clinical staff explain the treatment to you sufficiently? Always	11. Did our clinical staff explain the treatment to you sufficiently? Usually	11. Did our clinical staff explain the treatment to you sufficiently? Sometimes	11. Did our clinical staff explain the treatment to you sufficiently? Rarely	11. Did our clinical staff explain the treatment to you sufficiently? Never	11. Did our clinical staff explain the treatment to you sufficiently? N/A
12. Did our staff provide a treatment estimate before the treatment was started?	12. Did our staff provide a treatment estimate before the treatment was started? Always	12. Did our staff provide a treatment estimate before the treatment was started? Usually	12. Did our staff provide a treatment estimate before the treatment was started? Sometimes	12. Did our staff provide a treatment estimate before the treatment was started? Rarely	12. Did our staff provide a treatment estimate before the treatment was started? Never	12. Did our staff provide a treatment estimate before the treatment was started? N/A
13. If applicable did our clinical staff provide satisfactory instructions for any post treatment care? (i.e. extractions, root canals etc)	13. If applicable did our clinical staff provide satisfactory instructions for any post treatment care? (i.e. extractions, root canals etc) Always	13. If applicable did our clinical staff provide satisfactory instructions for any post treatment care? (i.e. extractions, root canals etc) Usually	13. If applicable did our clinical staff provide satisfactory instructions for any post treatment care? (i.e. extractions, root canals etc) Sometimes	13. If applicable did our clinical staff provide satisfactory instructions for any post treatment care? (i.e. extractions, root canals etc) Rarely	13. If applicable did our clinical staff provide satisfactory instructions for any post treatment care? (i.e. extractions, root canals etc) Never	13. If applicable did our clinical staff provide satisfactory instructions for any post treatment care? (i.e. extractions, root canals etc) N/A
14. If your appointment was an emergency appointment was it easy to reach us or one of our clinical staff during non business hours?	14. If your appointment was an emergency appointment was it easy to reach us or one of our clinical staff during non business hours? Always	14. If your appointment was an emergency appointment was it easy to reach us or one of our clinical staff during non business hours? Usually	14. If your appointment was an emergency appointment was it easy to reach us or one of our clinical staff during non business hours? Sometimes	14. If your appointment was an emergency appointment was it easy to reach us or one of our clinical staff during non business hours? Rarely	14. If your appointment was an emergency appointment was it easy to reach us or one of our clinical staff during non business hours? Never	14. If your appointment was an emergency appointment was it easy to reach us or one of our clinical staff during non business hours? N/A

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3. Are there any areas in communication or treatment you feel we could improve upon?

Are there any areas in communication or treatment you feel we could improve upon? yes

If so, what? (please specify)

4. Would additional office hours be more convenient to you?

Would additional office hours be more convenient to you? 1. 7am-8am Monday - Friday

2. 5pm-6pm Monday - Thursday

3. 6pm-7pm Monday - Thursday

4. 7pm-8pm Monday - Thursday

5. 1:30pm-5pm Fridays

6. Saturday mornings

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5. Do you feel confident referring your family members, friends, or co-workers to our practice?

Do you feel confident referring your family members, friends, or co-workers to our practice? yes

If not, why? (please specify)

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6. Was our office easy to find?

Was our office easy to find? yes

7. If there were one thing we could do to improve our quality of care or service, what would that be?

If there were one thing we could do to improve our quality of care or service, what would that be?

8. If there are any other comments or concerns you would like to share with us, please use the space provided

If there are any other comments or concerns you would like to share with us, please use the space provided

9. May we use your comments in print and/or on our website?

May we use your comments in print and/or on our website? yes

10. Thank you for taking the time to complete this survey. Your feedback is very important to us! We use comments to better serve our patients. If you would like us to contact you about any questions or concerns you have, please provide us with your information below.

Thank you for taking the time to complete this survey. Your feedback is very important to us! We use comments to better serve our patients. If you would like us to contact you about any questions or concerns you have, please provide us with your information below. Name:
Email Address:
Phone Number:

Hammond Customer Satisfaction Survey
Exit this survey

1. Default Section

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1. Which dental care provider did you see during your last visit?

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2. Please choose the response that best reflects your answer based on the rating scale below:
1 = Always
2 = Usually
3 = Sometimes
4 = Rarely
5 = Never
6 = N/A

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3. Are there any areas in communication or treatment you feel we could improve upon?

4. Would additional office hours be more convenient to you?

*
5. Do you feel confident referring your family members, friends, or co-workers to our practice?

*
6. Was our office easy to find?

7. If there were one thing we could do to improve our quality of care or service, what would that be?

8. If there are any other comments or concerns you would like to share with us, please use the space provided

9. May we use your comments in print and/or on our website?

10. Thank you for taking the time to complete this survey. Your feedback is very important to us! We use comments to better serve our patients. If you would like us to contact you about any questions or concerns you have, please provide us with your information below.

Hammond Customer Satisfaction SurveyExit this survey

1. Default Section

*1. Which dental care provider did you see during your last visit?

*2. Please choose the response that best reflects your answer based on the rating scale below:1 = Always2 = Usually 3 = Sometimes 4 = Rarely5 = Never6 = N/A

*3. Are there any areas in communication or treatment you feel we could improve upon?

4. Would additional office hours be more convenient to you?

*5. Do you feel confident referring your family members, friends, or co-workers to our practice?

*6. Was our office easy to find?

7. If there were one thing we could do to improve our quality of care or service, what would that be?

8. If there are any other comments or concerns you would like to share with us, please use the space provided

9. May we use your comments in print and/or on our website?

10. Thank you for taking the time to complete this survey. Your feedback is very important to us! We use comments to better serve our patients. If you would like us to contact you about any questions or concerns you have, please provide us with your information below.

Hammond Customer Satisfaction Survey
Exit this survey

*
1. Which dental care provider did you see during your last visit?

*
2. Please choose the response that best reflects your answer based on the rating scale below:
1 = Always
2 = Usually
3 = Sometimes
4 = Rarely
5 = Never
6 = N/A

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3. Are there any areas in communication or treatment you feel we could improve upon?

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5. Do you feel confident referring your family members, friends, or co-workers to our practice?

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6. Was our office easy to find?