Family Dentist | Fort Myers, FL | Children & Adult Dentistry

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Please choose the response that best reflects your answer based on the rating scale below:

1 = Always | 2 = Sometimes | 3 = Never

1. Is it easy to make an appointment?

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2

3

2. Do we answer the phone promptly and politely?

1

2

3

3. Does the receptionist check back within an appropriate time when kept on hold?

1

2

3

4. Do we return your calls promptly?

1

2

3

5. Are you greeted pleasantly upon arrival?

1

2

3

6. Is our reception area clean and comfortable?

1

2

3

7. Do we see you on time?

1

2

3

8. Does our staff seem genuinely interested in you?

1

2

3

9. Are our exam rooms clean and comfortable?

1

2

3

10. Are you treated with compassion and respect?

1

2

3

11. Does the doctor and staff spend sufficient time with you?

1

2

3

12. Are the doctor and staff attentive to your needs and concerns?

1

2

3

13. Are all of your questions answered satisfactorily?

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3

14. Do you receive satisfactory instructions to your questions regarding prescribed treatment and medication, if applicable?

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2

3

15. Do we give you complete information regarding insurance coverage, copayments and fees?

1

2

3

16. In an emergency, is it easy for you to get in touch with our office?

1

2

3

Are there any areas in communication or treatment you feel we could improve upon?

Yes

No

If so, what?

Do you feel confident referring your friends, family members or colleagues to our practice?

Yes

No

Why?

Are our office hours convenient for your schedule?

Ye

No

If not, what hours would be more convenient?

Is our office easy to find?

Yes

No

If there were one thing we could do to improve our quality of care or service, what would it be?

If there are any other comments or concerns you would like to share with us, please use the space provided.

May we use any of your comments in print and/or on our website?

Yes

No

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Thank you for taking the time to complete this survey. Your feedback is very valuable to us!

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Patient Satisfaction Survey