PATIENT SATISFACTION SURVEY

1. How did you first hear about Abington Dental Associates, Inc.?

How did you first hear about Abington Dental Associates, Inc.? Friend or Family Member

Building Signage

Yellow Book/Yellow Pages

Internet/Web Page

Don't remember

Other (please specify)

2. What influenced you to choose us as your dental office? {Please choose all that apply}

What influenced you to choose us as your dental office? {Please choose all that apply} Convenient Hours/Days

Friendly Staff

Services Offered

Quality of work

Location

Technology in Office

Technology in office

Other (please specify)

3. How long have you been a regular patient with us?

How long have you been a regular patient with us? Less than 1 year

1-2 years

3-5 years

5-10 years

Greater than 10 years

4. How often do you typically make dental appointments?

How often do you typically make dental appointments? Every 3 months

Every 4 months

Every 6 months

Yearly

Only when I have pain

Other (please specify)

5. How would rate us in the following areas:

	Extremely Poor	Poor	Good	Very Good	Excellent	N/A
LOCATION	*How would rate us in the following areas: LOCATION Extremely Poor	LOCATION Poor	LOCATION Good	LOCATION Very Good	LOCATION Excellent	LOCATION N/A
BUSINESS HOURS	BUSINESS HOURS Extremely Poor	BUSINESS HOURS Poor	BUSINESS HOURS Good	BUSINESS HOURS Very Good	BUSINESS HOURS Excellent	BUSINESS HOURS N/A
FRIENDLINESS OF STAFF	FRIENDLINESS OF STAFF Extremely Poor	FRIENDLINESS OF STAFF Poor	FRIENDLINESS OF STAFF Good	FRIENDLINESS OF STAFF Very Good	FRIENDLINESS OF STAFF Excellent	FRIENDLINESS OF STAFF N/A
SKILL OF YOUR DENTIST	SKILL OF YOUR DENTIST Extremely Poor	SKILL OF YOUR DENTIST Poor	SKILL OF YOUR DENTIST Good	SKILL OF YOUR DENTIST Very Good	SKILL OF YOUR DENTIST Excellent	SKILL OF YOUR DENTIST N/A
SKILL OF YOUR HYGIENIST	SKILL OF YOUR HYGIENIST Extremely Poor	SKILL OF YOUR HYGIENIST Poor	SKILL OF YOUR HYGIENIST Good	SKILL OF YOUR HYGIENIST Very Good	SKILL OF YOUR HYGIENIST Excellent	SKILL OF YOUR HYGIENIST N/A
SKILL OF SUPPORT STAFF	SKILL OF SUPPORT STAFF Extremely Poor	SKILL OF SUPPORT STAFF Poor	SKILL OF SUPPORT STAFF Good	SKILL OF SUPPORT STAFF Very Good	SKILL OF SUPPORT STAFF Excellent	SKILL OF SUPPORT STAFF N/A
PAIN CONTROL	PAIN CONTROL Extremely Poor	PAIN CONTROL Poor	PAIN CONTROL Good	PAIN CONTROL Very Good	PAIN CONTROL Excellent	PAIN CONTROL N/A
COST OF SERVICES	COST OF SERVICES Extremely Poor	COST OF SERVICES Poor	COST OF SERVICES Good	COST OF SERVICES Very Good	COST OF SERVICES Excellent	COST OF SERVICES N/A
FILING OF INSURANCE CLAIMS	FILING OF INSURANCE CLAIMS Extremely Poor	FILING OF INSURANCE CLAIMS Poor	FILING OF INSURANCE CLAIMS Good	FILING OF INSURANCE CLAIMS Very Good	FILING OF INSURANCE CLAIMS Excellent	FILING OF INSURANCE CLAIMS N/A
TREATMENT WAS EXPLAINED WELL	TREATMENT WAS EXPLAINED WELL Extremely Poor	TREATMENT WAS EXPLAINED WELL Poor	TREATMENT WAS EXPLAINED WELL Good	TREATMENT WAS EXPLAINED WELL Very Good	TREATMENT WAS EXPLAINED WELL Excellent	TREATMENT WAS EXPLAINED WELL N/A
COMMUNICATION OF SERVICES AVAILABLE	COMMUNICATION OF SERVICES AVAILABLE Extremely Poor	COMMUNICATION OF SERVICES AVAILABLE Poor	COMMUNICATION OF SERVICES AVAILABLE Good	COMMUNICATION OF SERVICES AVAILABLE Very Good	COMMUNICATION OF SERVICES AVAILABLE Excellent	COMMUNICATION OF SERVICES AVAILABLE N/A
STERILIZATION PROCEDURES AND CLEANLINESS OF OFFICE	STERILIZATION PROCEDURES AND CLEANLINESS OF OFFICE Extremely Poor	STERILIZATION PROCEDURES AND CLEANLINESS OF OFFICE Poor	STERILIZATION PROCEDURES AND CLEANLINESS OF OFFICE Good	STERILIZATION PROCEDURES AND CLEANLINESS OF OFFICE Very Good	STERILIZATION PROCEDURES AND CLEANLINESS OF OFFICE Excellent	STERILIZATION PROCEDURES AND CLEANLINESS OF OFFICE N/A
COMFORTABLE ATMOSPHERE	COMFORTABLE ATMOSPHERE Extremely Poor	COMFORTABLE ATMOSPHERE Poor	COMFORTABLE ATMOSPHERE Good	COMFORTABLE ATMOSPHERE Very Good	COMFORTABLE ATMOSPHERE Excellent	COMFORTABLE ATMOSPHERE N/A

6. In which areas did we meet or exceed your expectations or fell short? {Please choose all that apply}

	Exceeded or Met My Expectations	Fell short of My Expectations	N/A
Treatment by Doctor	*In which areas did we meet or exceed your expectations or fell short? {Please choose all that apply} Treatment by Doctor Exceeded or Met My Expectations	Treatment by Doctor Fell short of My Expectations	Treatment by Doctor N/A
Hygiene Treatment	Hygiene Treatment Exceeded or Met My Expectations	Hygiene Treatment Fell short of My Expectations	Hygiene Treatment N/A
Management of discomfort	Management of discomfort Exceeded or Met My Expectations	Management of discomfort Fell short of My Expectations	Management of discomfort N/A
Waiting Time	Waiting Time Exceeded or Met My Expectations	Waiting Time Fell short of My Expectations	Waiting Time N/A
Ease of getting an appointment	Ease of getting an appointment Exceeded or Met My Expectations	Ease of getting an appointment Fell short of My Expectations	Ease of getting an appointment N/A
Services Offered	Services Offered Exceeded or Met My Expectations	Services Offered Fell short of My Expectations	Services Offered N/A
Quality of Care	Quality of Care Exceeded or Met My Expectations	Quality of Care Fell short of My Expectations	Quality of Care N/A
Organization	Organization Exceeded or Met My Expectations	Organization Fell short of My Expectations	Organization N/A
Sincerity of Staff	Sincerity of Staff Exceeded or Met My Expectations	Sincerity of Staff Fell short of My Expectations	Sincerity of Staff N/A
Overall Communication	Overall Communication Exceeded or Met My Expectations	Overall Communication Fell short of My Expectations	Overall Communication N/A
Financial Arrangements	Financial Arrangements Exceeded or Met My Expectations	Financial Arrangements Fell short of My Expectations	Financial Arrangements N/A
Value	Value Exceeded or Met My Expectations	Value Fell short of My Expectations	Value N/A
Sterilization	Sterilization Exceeded or Met My Expectations	Sterilization Fell short of My Expectations	Sterilization N/A
Technology	Technology Exceeded or Met My Expectations	Technology Fell short of My Expectations	Technology N/A
Feeling Comfortable and Special	Feeling Comfortable and Special Exceeded or Met My Expectations	Feeling Comfortable and Special Fell short of My Expectations	Feeling Comfortable and Special N/A

7. Would you recommend your friends and family to our office for their dental care?

Would you recommend your friends and family to our office for their dental care? Yes

Other (please specify)

8. What is the best way to communicate new services that we are offering or office specials? {Please choose all that apply}

What is the best way to communicate new services that we are offering or office specials? {Please choose all that apply} Newspaper Ad

Community Newsletter

Sign on our Building

Office Newsletter

Texting

Facebook

Postal Mail

Other (please specify)

9. In what age group do you fall into?

In what age group do you fall into? 20 years old or younger

21 to 40

41 to 60

61 or older

10. Do you have any recommendations or suggestions that we can do to improve your dental experience here at Abington Dental Associates?

Do you have any recommendations or suggestions that we can do to improve your dental experience here at Abington Dental Associates?

PATIENT SATISFACTION SURVEYExit this survey

1.

1. How did you first hear about Abington Dental Associates, Inc.?

2. What influenced you to choose us as your dental office? {Please choose all that apply}

3. How long have you been a regular patient with us?

4. How often do you typically make dental appointments?

5. How would rate us in the following areas:

6. In which areas did we meet or exceed your expectations or fell short? {Please choose all that apply}

7. Would you recommend your friends and family to our office for their dental care?

8. What is the best way to communicate new services that we are offering or office specials? {Please choose all that apply}

9. In what age group do you fall into?

10. Do you have any recommendations or suggestions that we can do to improve your dental experience here at Abington Dental Associates?

PATIENT SATISFACTION SURVEY
Exit this survey