Monday, 06 February 2012
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University Dental Associates Survey
University Dental Associates
- Raymond Garrison, DDS
TO OUR VALUED PATIENT:
In order to better serve you, we would appreciate your comments concerning your visit at University Dental Associates. Please take a few minutes to complete the questions accordingly. Pick the answer that most closely matches your response to the statments according to the scale below.
Who is your dentist? (*)
Response cannot be left blank.
Practice Location: (*)
Campus North - Raleigh
Clemmons Village West
Durham - Central Medical Park
Comprehab Plaza - Winston-Salem
Hawthorne Rd - Winston-Salem
Interchange - Raleigh
Preston Corners - Cary
South Park - Charlotte
University Place - Charlotte
Watlington Hall -Baptist Medical Center
Crown Point- Charlotte
Response cannot be left blank.
How long have you been a patient in this practice?
First Visit
Less than a year
1-2 years
2 or more years
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Pick the number that most closely matches your response according to the following scale:
1= Agree
2= Disagree
3= No opinion
NA= Not Applicable
I have been able to schedule appointments with ease in this practice.
1
2
3
NA
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I have been able to get through on the telephone line with ease when calling.
1
2
3
NA
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I am never put on hold for long periods of time when calling.
1
2
3
NA
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The front desk staff was courteous / pleasant when scheduling my appointment.
1
2
3
NA
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The appointment times / days are very convenient for me.
1
2
3
NA
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Parking is convenient for me.
1
2
3
NA
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I am seen on time for my appointments.
1
2
3
NA
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I am satisfied with my treatment in this practice.
1
2
3
NA
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The dentist was sensitive to my comfort and fully explained my dental problems to me.
1
2
3
NA
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My dental assistant(s) was courteous to me.
1
2
3
NA
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My dental hygienist(s) was courteous to me.
1
2
3
NA
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I am satisfied with my payment arrangements and billing procedures in this practice.
1
2
3
NA
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I would recommend this office to others.
1
2
3
NA
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Have any of our staff been particularly helpful?
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Comments or suggestions:
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Your name:
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Email
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Date:
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Plese fill in the letters in the picture.
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