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Lytle Family Dental - Patient Satisfaction Survey
Please rank your visit below by clicking on the appropriate ranking for each question below.
*
1.
Wait time before being seen:
(Required.)
Highly Unsatisfied
Somewhat Unsatisfied
Neutral
Somewhat Satisfied
Highly Satisfied
Highly Unsatisfied
Somewhat Unsatisfied
Neutral
Somewhat Satisfied
Highly Satisfied
*
2.
Explanation of treatment and attentiveness to your questions:
(Required.)
Highly Unsatisfied
Somewhat Unsatisfied
Neutral
Somewhat Satisfied
Highly Satisfied
Highly Unsatisfied
Somewhat Unsatisfied
Neutral
Somewhat Satisfied
Highly Satisfied
*
3.
Explanation of financial options:
(Required.)
Highly Unsatisfied
Somewhat Unsatisfied
Neutral
Somewhat Satisfied
Highly Satisfied
Highly Unsatisfied
Somewhat Unsatisfied
Neutral
Somewhat Satisfied
Highly Satisfied
*
4.
Cleanliness of our office:
(Required.)
Highly Unsatisfied
Somewhat Unsatisfied
Neutral
Somewhat Satisfied
Highly Satisfied
Highly Unsatisfied
Somewhat Unsatisfied
Neutral
Somewhat Satisfied
Highly Satisfied
*
5.
How would you describe the caregivers at our dental office?
(Required.)
Unfriendly
Unhelpful
Friendly
Helpful
Caring and Sympathetic
Check-In
Unfriendly
Unhelpful
Friendly
Helpful
Caring and Sympathetic
Dental Assistant
Unfriendly
Unhelpful
Friendly
Helpful
Caring and Sympathetic
Dentist
Unfriendly
Unhelpful
Friendly
Helpful
Caring and Sympathetic
Hygienist
Unfriendly
Unhelpful
Friendly
Helpful
Caring and Sympathetic
Office Manager
Unfriendly
Unhelpful
Friendly
Helpful
Caring and Sympathetic
Check-Out
Unfriendly
Unhelpful
Friendly
Helpful
Caring and Sympathetic
*
6.
On a scale of 0 to 10,
How likely is it that you would recommend our dental office to a friend or colleague?
0 for Not at all likely, 10 for Extremely likely
(Required.)
Not at all likely
Extremely likely
0
1
2
3
4
5
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8
9
10
7.
Is there anything else we could do to improve your dental experience?