Patient Questionnaire

We want to provide you with the very best possible personal care and service that meets your needs. To do this it is important that we know how you find the practice and the care we provide and to gain your views on where we can improve. We would be grateful if you would spend five minutes completing this survey.

How did you hear about the Dental Centre?	NHS DirectPrimary Care TrustLocal AdvertisementRecommendedOther
If other.. please state
What attracts you most about the practice?
What do you like least about the practice?
Receipt of recall
Did you find it easy to book an appointment?
Are you happy to be recalled for your dental appointment?
Did you receive a confirmation call?
Are you aware that you can choose which dentist you see?
Reception
Are the receptionists as helpful as you think they should be?
Were you dealt with efficiently?
Did you have to wait long for a future appointment?
Comments and suggestions for improvement
Waiting Room
Is the waiting room comfortable and relaxing?
Is there enough for children to do?
Is there enough for you to do?
Are there enough dental leaflets?
Does the Practice Information Leaflet contain enough information?
Dental Clinic
Were you seen for your appointment on time?
If no, how long did you have to wait?
Were you made aware of the expected delay?
Did your dentist make you feel welcome?
Did your dentist treat you with courtesy and respect?
Did your dentist enquire about your medical history?
In your opinion, does your dentist know enough about your medical history?
Do you feel your treatment was fully explained?
Did you understand the charges that would be incurred for your treatment?
Did you receive a treatment plan?
Did you feel confident about the quality of treatment you were being provided?
Are you aware the practice has a dental hygienists?
Would you prefer to have your teeth cleaned by a dentist or hygienist?
Would your recommend the practice to others?
Yes I consent to my personal data being collected and stored as per the Privacy Policy.
Yes I consent to my personal data being collected and stored for the purpose of marketing communications.

Monday	8 am – 5 pm
Tuesday	8 am – 6 pm
Wednesday	8 am – 5 pm
Thursday	8 am – 7 pm
Friday	8 am – 5 pm
Saturday	9 am – 4 pm
Sunday	Closed

Tel:01205 400 000

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Appointments

Receipt of recall

Reception

Waiting Room

Dental Clinic

Hours

Address