Church Health Dental Patient Satisfaction Survey Question Title * 1. Survey completed in: English Spanish OK Question Title * 2. Who did you see today for your treatment? April- Hygienist Liz- Hygienist Tori- Hygienist Joanna- Hygienist Brittany - Hygienist Hannah - Hygienist Dr. Oxner Dr. Fergus Dr. Gaither Dr. Flex Dr. Hodge Other: __________________ OK Question Title * 3. How likely are you to refer a friend or family member to Church Health? Highly Likely Likely Neutral/Unsure Unlikely Highly Unlikely OK Question Title * 4. In general, how would you rate your overall oral health? Excellent Very Good Good Fair Poor OK Question Title * 5. I was seen at my scheduled appointment time. Strongly Agree Agree Neutral/Unsure Disagree Strongly Disagree OK Question Title * 6. My dental care team explained my treatment plan in a way that was easy for me to understand. Strongly Agree Agree Neutral/Unsure Disagree Strongly Disagree OK Question Title * 7. My dental care team spent enough time with me. Strongly Agree Agree Neutral/Unsure Disagree Strongly Disagree OK Question Title * 8. My dental care team treated me as a partner in caring for my dental health. Strongly Agree Agree Neutral/Unsure Disagree Strongly Disagree OK Question Title * 9. Any other comments: OK DONE