Dentistry - Outreach feedback tool - Feb 2023

1. How easy or difficult have you found it to book a dental appointment?

2. Have you seen a dentist for treatment during the last two years?

Yes (Go to Q3)
No (Go to Q5)

3. Were you able to get all the treatment you needed at NHS prices?

Yes[go to Q5]
No [go to Q4]
Partially [go to Q4]

4. Please tell us why you didn’t get the dental treatment you needed at NHS prices?

5. Would you recommend your dental practice to others?

Yes - my dental practice Is:___________________[Inc post code] and I would recommend them to others because________________________________________
No - my dental practice Is _____________________[inc post code] and I would not recommend them to others because____________________________________________

6. What is your age?

7. Do you have a disability or long-term condition?

Yes
No
Prefer not to say

8. Are you a carer or do you regularly look after a family member, partner or friend who needs help because of their illness, frailty, disability, a mental health problem or an addiction?

Yes
No
Prefer not to say

9. What is your gender?

10. What is your ethnicity?

11. If you want to provide further information regarding your experience please give us your name and email/phone number:

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