Patient Survey Form

So that we may serve you better, please take a moment to answer the following questions.

This survey is completely anonymous.

1. Was this your first visit to the practice?

YesNo

2. Which clinician did you see?

Dr. Alex Loh

3. Rate your experience when speaking the practice on the phone and the reception you received on arrival.

Improvable 12345678910   Perfect

4. How preferred/convenient was the time you were able to book for your appointment?

Improvable12345678910   Perfect

5. How long did you have to wait to be seen by your dentist?

More than 15 mins15 mins10 mins5 mins lateI was seen on time

6. How happy are you with the information offered to you by the dentist regarding your treatment and procedures?

Very unhappy12345678910   Very happy

7. How would you rate the efficiency and effectiveness of the Assistant?

Improvable12345678910   Perfect

8. Were our staff members professional, friendly and caring?

Not at all12345678910   Very much so

9. How satisfied are you with the outcome of your dental treatment?

Not satisfied12345678910   Very satisfied

10. How likely are you to recommend eDentistry to family and friends?

Not likely12345678910   Extremely likely

Thank you for taking the time to complete our survey.

Please feel free to leave a comment in the box below regarding any area that you believe we could enhance to help make your experience more positive.

Any feedback is valuable to our practice and assists us in making your dental experience a positive one.

Please leave your name if you'd like us to know who this was from.