Patient Feedback

Happy or Sad? Give us your feed back to help encourage and improve services. As well as completing the form below, you can also ask for a feedback form at reception.

Patient Feedback Survey

Any field marked with * is mandatory

How satisfied were you with the time you had to wait for an appointment?
Appointment time
Very satisfied
Quite satisfied
Could be better
Not at all

Were you treated with dignity and respect by the staff at the practice?
I was treated
Very well
Quite well
Could be better

How satisfied are you that the dental practice involved you in decisions about your care?
I was
Totally involved
Quite a lot
More or less involved
Not very involved
Not at all involved

How satisfied are you with the information about the charges for your NHS treatment, provided to you at the practice?
The information is
Very good
Quite good
Could be better
Not good enough

How satisfied are you with your dental treatment?
I am
Very satisfied
Quite satisfied
Not very satisfied
Not at all satisfied

Other Comments
Telephone number
E-mail address
Tick if ok for us to contact you for more information (make sure you've given us your email address or phone number)

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