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Pinecrest Dental Satisfaction Survey: How Was Your Care This Week? This survey will take less than 3 minutes, and you'll be entered to win one of 3 $10 Lunch Giftcards!
Thanks for your feedback! -Dr. Tyler Williams
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1.
How satisfied are you with Pinecrest Dental?
(Required.)
Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat dissatisfied
Very dissatisfied
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2.
I feel Pinecrest Dental always delivers on what they promise.
(Required.)
Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
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3.
Pinecrest Dental treats me fairly and respectfully.
(Required.)
Strongly Agree
Agree
Somewhat Agree
Somewhat Disagree
Disagree
Strongly Disagree
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4.
On a scale of 0 to 10,
How likely is it that you would recommend Pinecrest Dental to a friend or colleague?
0 for Not at all likely, 10 for Extremely likely
(Required.)
Not at all likely
Extremely likely
0
1
2
3
4
5
6
7
8
9
10
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5.
If a problem arises, I can always count on Pinecrest Dental to reach a fair resolution.
(Required.)
Strongly Agree
Agree
Somewhat Agree
Somewhat Disagree
Disagree
Strongly Disagree
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6.
Which of the following words would you use to describe our services? (Select all that apply.)
(Required.)
Reliable
High quality
Useful
Unique
Good value for money
Overpriced
Impractical
Ineffective
Poor quality
Unreliable
7.
For our next charity, which organization would you prefer we make a donation to on your behalf?
Salt Lake Donated Dental Services
Horizon Elementary
The Oral Cancer Foundation
The Veterans Hospital
Other (please specify)
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8.
What is your preferred day of the week for appointments? (Check 1 or 2 of your preferred day boxes)
(Required.)
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Other (please specify)
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9.
What is your preferred time of day for appointments?
(Required.)
Morning (7-9 AM)
Mid Day (10AM-2PM)
Afternoon (2-4PM)
Evening (4-7PM)
Saturday Morning (9AM-12PM)
Saturday Afternoon (12-2PM)
Other (please specify)
10.
Any comments (optional-confidential)
11.
Your name (optional and confidential).