Port Macquarie Wauchope Bonny Hills dentistry cosmetic invisalign implants

Port Macquarie ✆ 6583 8868

Bonny Hills ✆ 6585 5772

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Online Survey

Port Smiles Dental Online Survey

Dental Patient Care Survey

First Name: *

Last Name: *

Phone:

Email: *

1. Was this your first visit to Port Smiles Dental?

New

Existing

2. Please choose your gender

Male

Female

3. Which provider did you see?

Dentist

Dental Hygienist

Both

4. Do you find Front Office staff are pleasant and helpful on the phone?

Yes

Sometimes

5. Were you seen by the provider on time?

On Time

5 mins late

10 mins late

15 mins late

20 mins late

Over 20 mins late

6. How well did you feel the Dentist/Hygienist and team worked together?

Perfect

Good

Normal

Poor

Terrible

7. Was your presenting dental problem addressed by the dentist / hygienist in a manner that you were comfortable with?

Yes

8. How clearly did the Dentist/Hygienist explain any treatment options to you?

Perfect

Good

Normal

Poor

Terrible

9. How would you rate this practice overall for cleanliness and tidiness of appearance?

Perfect

Good

Normal

Poor

Terrible

10. Would you refer your family and friends?

Strongly Agree

Agree

Unsure

Disagree

Strongly Disagree

Additional Feedback:

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Port Smiles Dental

46 Lord Street - Port Macquarie

✆ 02 6583 8868

10 Jungarra Crescent - Bonny Hills

✆ 02 6585 5772

Treatments

Orthodontic Treatment

Customer Care

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