Patient Satisfaction Survey
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Patient Satisfaction Survey

We care about the level of service we provide to you. We would be grateful if you would fill out this survey to let us know what you like about our practice as a patient of Marshall Family Dentistry and to also let us know what areas we need to take action to correct and improve our services to you.

We are working with an independent company, practice management institute. The results of this survey will be private and confidential. This survey is to improve our level of care to you. We respect your privacy.

1. What did you have done today?
Cleaning
Other

What did you have done today? Cleaning Other

2. When you telephone to make an appointment was staff courteous and helping in finding a suitable time?
Yes
No
Comments

When you telephone to make an appointment was staff courteous and helping in finding a suitable time? Yes No Comments

3. Was our staff caring and friendly?
Yes
No
Comments

Was our staff caring and friendly? Yes No Comments

4. Did cleanliness and infection control of our practice meet your expectations?
Exceeded
Meet
Below
Comments

Did cleanliness and infection control of our practice meet your expectations? Exceeded Meet Below Comments

5. Did we begin your appointment on time?
Yes
No
Comments

Did we begin your appointment on time? Yes No Comments

6. Did the Doctor/Hygentist/Assistant explain his/her diagnoses and treatment options clearly?
Yes
No
Comments

Did the Doctor/Hygentist/Assistant explain his/her diagnoses and treatment options clearly? Yes No Comments

7. Did the staff listen, understand all your needs, and answer all your questions?
Yes
No
Comments

Did the staff listen, understand all your needs, and answer all your questions? Yes No Comments

8. Where there any problems during your visit? if so, please describe them so we may address them at our daily morning meetings?

Where there any problems during your visit? if so, please describe them so we may address them at our daily morning meetings?

9. Was there a staff member that was particularly caring and helpful that you would like to thank or a staff member that needs to address any issues that were not dealt with to your satisfaction at your visit?

Was there a staff member that was particularly caring and helpful that you would like to thank or a staff member that needs to address any issues that were not dealt with to your satisfaction at your visit?

10. Would you recommend our dental office to a friend, relative, or co-worker?
Yes
No
Comments

Would you recommend our dental office to a friend, relative, or co-worker? Yes No Comments

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