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Questionnaire

Full Name (Optional)
Date of appointment (Optional)
Time (Optional)
 

If you attended for an Exam did you receive a recall letter for this appointment?

Yes No
 

Were the staff polite and helpful when booking your appointment?

Yes No
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Were you greeted in a professional and friendly manner?

Yes No
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Did you find the waiting area comfortable?

Yes No
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Did you see your dentist at your designated appointment time?

Yes No
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If your dentist was running more than 10 minutes late were you kept informed?

Yes No
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Were you informed by your dentist what was going to happen at your appointment?

Yes No
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Did your dentist and nurse put you at ease?

Yes No
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How would you rate your treatment?

Unsatisfied Satisfied Very satisfied
 

Would you recommend the practice to family and friends?

Yes No
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Can you suggest ways of improving our practice?

Yes No
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