Colchester Dental Referral Centre

841 The Crescent

Colchester Business Park

Colchester

CO4 9YQ

Tel: 01206 756 813

Fax: 01206 854 767

Patient Feedback Form

First Name:

Surname:

Email:

1 = Strongly Agree or 4 = Strongly Disagree

1. Do we answer the phone promptly and politely?

1
2
3
4

2. Do you feel that clinical and nursing staff explain themselves well?

1
2
3
4

3. Do we see you on time?

1
2
3
4

4. Is our reception area clean and comfortable?

1
2
3
4

5. In an emergency, is it easy for you to get in touch with our practice?

1
2
3
4

6. Are you greeted pleasantly upon arrival?

1
2
3
4

7. Do you feel the dentist, hygienist and nursing staff are attentive to your needs and concerns?

1
2
3
4

8. Do our staff spend adequate time with you?

1
2
3
4

9. Are you referring your friends and colleagues to our practice?
If not, why?

Yes
No

10. Are you pleased with the results you are seeing?

Yes
No

11. Is our practice easy to find?

Yes
No

12. What do you like or dislike most about our practice?

Like

Dislike

13. What would make your experience at our practice even better?

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Oasis Healthcare Support Centre, Vantage Park, Old Gloucester Road, Hambrook, Bristol BS16 1GW. Registered in England and Wales No: 478127


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Last updated: 25/4/2018 at 17:30 GMT