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Patient Satisfaction Survey

Our practice is committed to 100% satisfaction. We hope that you have had a comfortable, pleasant experience in our office and we want you to be excited about all of the services we provide. We value your opinion and would greatly appreciate it if you would take a moment to share your impressions of our practice. We will use the information gathered from this survey to make positive changes in how we provide care to our patients. Thank you for your time!
A = Excellent    B = Average    C = Could be improved
1. Friendliness of staff.
2. The value of the services we provide.
3. The quality of our service.
4. Treatment area was clean and attractive.
5. Reception room was comfortable.
6. Doctor was gentle.
7. All your questions were answered to your satisfaction.
8. Hygienists were gentle.
9. Chair-side assistants were gentle.
10. Dental hygienists were knowledgeable and courteous.
11. Doctor was helpful and knowledgeable.
12. Courteousness and concern of chair-side assistants.
13. Front desk personnel was professional and courteous.
14. We were on time for you.
15. Treatment consultations were comprehensive
16. The front team was courteous and helpful.
17. Scheduling of appointments worked for you.
18. Would you recommend our office to your friends?
 
Do you have any additional comments that would help us to improve?
Comments:
name:
phone:
email:
 
 

Joseph A. Mika, DDS • (330) 702-6000
3700 Stutz Dr, Ste 3 • Canfield, OH 44406