What was the date of your visit? (Required)
Do you usually wait more than 15 minutes for a scheduled appointment? Do you usually wait more than 15 minutes for a scheduled appointment? Always Sometimes Never
During your appointment, does your dentist appear familiar with you chart and dental history? During your appointment, does your dentist appear familiar with you chart and dental history? Always Sometimes Never
Does your dentist explain why treatment is recommended? Does your dentist explain why treatment is recommended? Always Sometimes Never
Does your dentist answer your questions and explain thing clearly? Does your dentist answer your questions and explain thing clearly? Always Sometimes Never
Does your dentist spend enough time with you? Does your dentist spend enough time with you? Always Sometimes Never
Are you treated courteously and respectfully by your dentist and staff? Are you treated courteously and respectfully by your dentist and staff? Always Sometimes Never
Do you see your dentist as being approachable, sympathetic, and understanding? Do you see your dentist as being approachable, sympathetic, and understanding? Always Sometimes Never
Your Hygienist
What was the date of your visit? (Required)
Do you usually wait more than 15 minutes for a scheduled appointment? Do you usually wait more than 15 minutes for a scheduled appointment? Always Sometimes Never
During your appointment, does your Dental Hygienist appear familiar with you chart and dental history? During your appointment, does your Dental Hygienist appear familiar with you chart and dental history? Always Sometimes Never
Does your Dental Hygienist explain why treatment is recommended? Does your Dental Hygienist explain why treatment is recommended? Always Sometimes Never
Does your Dental Hygienist answer your questions and explain thing clearly? Does your Dental Hygienist answer your questions and explain thing clearly? Always Sometimes Never
Does your Dental Hygienist spend enough time with you? Does your Dental Hygienist spend enough time with you? Always Sometimes Never
The Office
Is the office clean, comfortable and professional in appearance? clean, comfortable and professional office Always Sometimes Never
Is adequate parking available? Adequate parking available Always Sometimes Never
Is there a variety of appropriate reading material available in the reception area? Reading material available Always Sometimes Never
Is the telephone answered promptly? Answering the phone promptly Always Sometimes Never
Are you able to get an appointment in what you consider to be a reasonable amount of time? Getting an appointment in a reasonable time. Always Sometimes Never
Does the office staff assist you in filling out insurance and other forms? Assisting you in filling out forms Always Sometimes Never
Does the office staff maintain your privacy when discussing financial arrangement and other personal matters with you? Maintaining your privacy Always Sometimes Never
Does the office staff notify you if appointments are running behind schedule? Notified if appointments are running behind schedule Always Sometimes Never
Would you refer your friends and family to Aden Dental? Refer your friends and family Yes No
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