PATIENT SATISFACTION SURVEY

A - YOUR APPOINTMENT:
1- Ease of making appointments:
2- Getting after-hours care when your child needed it:

B - OUR STAFF:
3- The friendliness and courtesy of our staff:
4- Your phone calls answered promptly:

C - YOUR VISIT WITH THE PROVIDER:
5- Willingness to listen carefully to you (or your kid):
6- Taking time to answer your questions:

D - YOUR OVERALL SATISFACTION WITH:
7- Overall rating for your kids' dental care:
8- Would you recommend this practice to your friends and family members:

Your Name (optional):
Your Email Address (optional):