HeySurvey survey

Dental Patient Feedback Survey

We value your input as a patient. This survey aims to help us understand your experiences and expectations regarding your dental care. Your feedback will be kept confidential and is essential for improving our services.

How satisfied were you with the cleanliness of our dental clinic during your last visit?*

Please focus on waiting areas, treatment rooms, and restroom facilities.

From Not at all satisfied to Very satisfied

Which dental services have you received at our clinic?*

Select all that apply so we can understand the range of care you have experienced.

Routine exam/cleaning
Fillings or restorative work
Orthodontic treatment (braces, aligners)
Tooth extraction
Cosmetic dentistry (whitening, veneers)
Emergency dental care
Other

How easy was it to schedule your last dental appointment?*

We want to know if our appointment process meets your needs.

Very easy
Somewhat easy
Difficult
Very difficult

Please describe anything that made your dental visit especially comfortable or uncomfortable.

Share specific factors such as interactions with staff, the environment, or other details.

How clearly did the dentist or hygienist explain your treatment options?*

Clarity helps patients make informed choices about their dental health.

From Not clear at all to Very clear

Did you experience any pain or discomfort during your treatment?*

Your comfort during care is very important to us.

No pain or discomfort
Minor discomfort
Moderate pain
Severe pain

What, if any, concerns do you have about your dental health at the moment?

Let us know your main dental health concerns or questions.

How likely are you to recommend our dental clinic to family or friends?*

Your recommendation is a key indicator of your satisfaction.

From Not at all likely to Extremely likely

What could we do to improve your overall experience as a dental patient?*

Thank you for helping us deliver outstanding dental care!