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):