Thank You For Taking SmileMakers Dental Survey

We are concerned to ensure that patients who visit the practice receive a high standard of care. As you recently attended the practice it would be helpful if you could take a few minutes to complete this questionnaire to tell us of your experience.

What day did you visit us?
MondayTuesdayWednesdayThursdayFridaySaturday
Was it difficult to make an appointment?
YesNoDon't Know
Were your financial options explained to you?
YesNoDon't Know
Were you given the opportunity to ask questions?
YesNoDon't Know
Are you happy with the treatment you had?
YesNoDon't Know
Did you experience any pain during treatment?
YesNoDon't Know
If yes, did the dentist respond to your pain?
YesNo
Were you given any information on post-treatment care?
YesNoDon't Know
Although we try to see patients as promptly as possible, the nature of the service means that delays can occur. If you were kept waiting, do you feel the wait was unacceptably long?
YesNoDon't Know
(You may select more than one below)
How would you describe the dentist at the practice?
Caring and SympatheticHelpfulFriendlyUnhelpfulUnfriendly
How would you describe the dental hygienist at the practice?
Caring and SympatheticHelpfulFriendlyUnhelpfulUnfriendly
How would you describe the dental assistant at the practice?
Caring and SympatheticHelpfulFriendlyUnhelpfulUnfriendly
How would you describe the dental receptionist at the practice?
Caring and SympatheticHelpfulFriendlyUnhelpfulUnfriendly
How would you rate your overall visit?
ExcellentVery GoodAverageNot So Good
Would you refer your friends and family to us?
YesNo
Please make any additional comments here: