Dental Survey Questions For Patients Survey

Your Dental Visit Feedback

Tell us about your most recent visit. Your feedback helps us improve patient care. Please avoid including names or private medical details.

What was the main reason for your visit?*

Choose one.

Routine checkup or cleaning
Tooth pain or another urgent concern
Filling, crown, or other dental treatment
Cosmetic dental care
Other

How easy was it to schedule your appointment?*

Think about finding a time that worked for you.

1

2

3

4

5

Very difficult to Very easy

How long did you wait past your appointment time?

Choose your best estimate.

I was seen on time or early
Less than 10 minutes
10–20 minutes
21–30 minutes
More than 30 minutes
Not sure

How clearly did the dental team explain your care?*

Consider explanations about your dental health and any recommended treatment.

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2

3

4

5

Not at all clearly to Very clearly

What helped you feel comfortable during your visit?

Select all that apply. If you select “None of these,” leave the other options unchecked.

Friendly, welcoming staff
Clear explanations before treatment
Gentle care during treatment
Breaks when I needed them
A clean, calm environment
None of these

How well did the team respond to your questions or concerns?*

Choose one.

Very well
Somewhat well
Not very well
Not at all well
I had no questions or concerns

How clear was the information about your expected costs?

Include any explanation of fees, insurance coverage, or payment options.

Very clear
Somewhat clear
Not very clear
Not at all clear
Costs were not discussed
Not applicable

Overall, how satisfied were you with your visit?*

Think about the full experience, from check-in to check-out.

1

2

3

4

5

Very dissatisfied to Very satisfied

What could we do to make your next visit better?

Share any suggestions or tell us what you would like us to keep doing.

Thank you for taking a part in this survey.

This is a HeySurvey survey template.