Patient Satisfaction Survey

1. Which Clinic Location?

Chelsea
Reigate

2. Clinic Appearance

	Excellent	Good	Average	Below Average
Decor	Decor Excellent	Decor Good	Decor Average	Decor Below Average
State of repair	State of repair Excellent	State of repair Good	State of repair Average	State of repair Below Average
Outside Appearance	Outside Appearance Excellent	Outside Appearance Good	Outside Appearance Average	Outside Appearance Below Average
Cleanliness	Cleanliness Excellent	Cleanliness Good	Cleanliness Average	Cleanliness Below Average

3. Reception

	Yes	No
Are reception staff helpful?	Are reception staff helpful? Yes	Are reception staff helpful? No
Have you been kept waiting at the clinic too long for a dentist/hygienist appointment?	Have you been kept waiting at the clinic too long for a dentist/hygienist appointment? Yes	Have you been kept waiting at the clinic too long for a dentist/hygienist appointment? No
Are you dealt with efficiently at reception?	Are you dealt with efficiently at reception? Yes	Are you dealt with efficiently at reception? No

4. Waiting Room

5. Clinics Personnel - Dentists

	Yes	No
Was the dentist helpful?	Was the dentist helpful? Yes	Was the dentist helpful? No
Was the dentist friendly?	Was the dentist friendly? Yes	Was the dentist friendly? No
Did the dentist listen to you?	Did the dentist listen to you? Yes	Did the dentist listen to you? No
Did you find the dentist easy to understand?	Did you find the dentist easy to understand? Yes	Did you find the dentist easy to understand? No
Did the dentist spend enough time talking to you?	Did the dentist spend enough time talking to you? Yes	Did the dentist spend enough time talking to you? No
Did the dentist answer your questions?	Did the dentist answer your questions? Yes	Did the dentist answer your questions? No
Do you feel confident about the quality of treatment?	Do you feel confident about the quality of treatment? Yes	Do you feel confident about the quality of treatment? No

Comments:

6. Practice Personnel - Nurse/Receptionist

	Yes	No
Are the staff helpful?	Are the staff helpful? Yes	Are the staff helpful? No
Are they friendly?	Are they friendly? Yes	Are they friendly? No
Do they listen to you?	Do they listen to you? Yes	Do they listen to you? No
Do they reassure you?	Do they reassure you? Yes	Do they reassure you? No

Comments:

7. Appointments

	Yes	No
Is it easy to book an appointment?	Is it easy to book an appointment? Yes	Is it easy to book an appointment? No
When booking an appointment was one available within a reasonable time?	When booking an appointment was one available within a reasonable time? Yes	When booking an appointment was one available within a reasonable time? No
Are the clinic times suitable for you?	Are the clinic times suitable for you? Yes	Are the clinic times suitable for you? No
Did you know you can book appointments online?	Did you know you can book appointments online? Yes	Did you know you can book appointments online? No

Comments:

8. Facilities

	Yes	No
Would you recommend others to the practice?	Would you recommend others to the practice? Yes	Would you recommend others to the practice? No

Comments:

9. Practice fees

	Yes	No
Do you feel the cost of treatment is fully explained?	Do you feel the cost of treatment is fully explained? Yes	Do you feel the cost of treatment is fully explained? No
Did you receive an estimate for the proposed treatment?	Did you receive an estimate for the proposed treatment? Yes	Did you receive an estimate for the proposed treatment? No
Do you think the practices treatment charges are reasonable?	Do you think the practices treatment charges are reasonable? Yes	Do you think the practices treatment charges are reasonable? No

Comments:

10. Why did you choose The Wellington Clinic as your preferred dental provider?

11. Do you have any suggestions for improving the practice?

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