Church Health Dental Patient Satisfaction Survey
1.
Survey completed in:
English
Spanish
2.
Who did you see today for your treatment?
April- Hygienist
Liz- Hygienist
Tori- Hygienist
Joanna- Hygienist
Brittany - Hygienist
Hannah - Hygienist
Dr. Oxner
Dr. Fergus
Dr. Gaither
Dr. Flex
Dr. Hodge
Other: __________________
3.
How likely are you to refer a friend or family member to Church Health?
Highly Likely
Likely
Neutral/Unsure
Unlikely
Highly Unlikely
4.
In general, how would you rate your overall oral health?
Excellent
Very Good
Good
Fair
Poor
5.
I was seen at my scheduled appointment time.
Strongly Agree
Agree
Neutral/Unsure
Disagree
Strongly Disagree
6.
My dental care team explained my treatment plan in a way that was easy for me to understand.
Strongly Agree
Agree
Neutral/Unsure
Disagree
Strongly Disagree
7.
My dental care team spent enough time with me.
Strongly Agree
Agree
Neutral/Unsure
Disagree
Strongly Disagree
8.
My dental care team treated me as a partner in caring for my dental health.
Strongly Agree
Agree
Neutral/Unsure
Disagree
Strongly Disagree
9.
Any other comments:
Current Progress,
0 of 9 answered