Shirley Road survey 1

Dear patients,
we would like to ask you to spend a few  moments to fill out this survey, This type of feedback from patients is encouraged by various health authorities and it will help us to improve our service, taking care of your smile. Thank you very much for your cooperation. Your team of the Shirley Road Dental Surgery.

* 1. Our records show that you got treatment from our dental surgery. Is that right?

* 2. How long have you been going to your dentist?

* 3. In the last 12 months, how many times did you visit your dentist?

* 4. In the last 12 months, when you made an appointment for a check-up or routine care with your dentist, how often did you get an appointment as soon as you needed?

* 5. Wait time includes time spent in the waiting room and exam room. During your most recent visit, did you see your dentist within 15 minutes of your appointment time?

* 6. During your most recent visit, did your dentist explain things in a way that was easy to understand?

* 7. During your most recent visit, did clerks and receptionists at our surgery’s office treat you with courtesy and respect?

* 8. Using any number from 0 to 10, where 0 is the worst provider possible and 10 is the best provider possible, what number would you use to rate our surgery?

  10 Best provider possible 9 8 7 6 5 4 3 2 1 0 Worst provider possible

* 9. How likely is it that you would recommend Shirley Road Dental Surgery to a friend or colleague?

Not at all likely
Extremely likely

* 10. Do you have any other comments, questions, or concerns?