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* 1. Waiting time. We aim to see all patients within 15 minutes. In your most recent visit, how long did you have to wait in the practice before you could be seen by the Dentist?

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* 2. Courtesy. During your visit, were you treated professionally and with respect by our staff?

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* 3. Decision. We always aim to fully involve patients in the process of decision making about their treatments. How satisfied are you that you were involved in the decisions about your treatment?

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* 4. Cost. It is our policy to provide all patients with a detailed treatment plan and a clear breakdown of costs before any treatment starts. How satisfied are you with the information given to you about the cost of your treatment?

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* 5. Treatment. How satisfied are you with the outcome of your treatment?

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* 6. Loyalty. How likely are you to come back to our practice for your future treatments?

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* 7. Recommendation. How likely are you to recommend our practice to family and friends?

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* 8. Stars. Overall, how many stars would you give to our practice?

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* 9. Dentist. Who is your dentist at our practice?

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* 10. Got it right. Please write a few things that you liked about our practice:

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* 11. Improvement. Please write a few things that you think we should improve in our practice:

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* 12. Thank you very much for your time and feedback! You can write any other comments you may have below. Please feel free to write your name as well (optional). Don't forget to click on 'Done' button to submit your feedback!

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