Toby Talbot
enquiries@talbotclinic.co.uk
+44 1225 426 222
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Patient feedback
Thank you for taking the time to complete this survey. Please fill out this form and click 'Submit' when complete.
Reason for attendance
*
Specify the service you received
Prosthodontics (replacement of missing teeth)
Periodontics (Treatment for gum disease)
Endodontics (Treatment of decaying and infected teeth
Implantology ('screw in teeth')
Restorative Dentistry (all of the above)
Second opinion
Other
Other reason
Please give brief description of the reason of your attendance
Rate the clarity of our fees
Very Satisfied
Satisfied
Neutral
Unsatisfied
Very Unsatisfied
Did we clearly state the costs prior to the service
Rate the clarity of directions to the clinic
Very Satisfied
Satisfied
Neutral
Unsatisfied
Very Unsatisfied
Did we provide adequate time for you to give the history of your problem
Very Satisfied
Satisfied
Neutral
Unsatisfied
Very Unsatisfied
Rate our punctuality and timekeeping
Very Satisfied
Satisfied
Neutral
Unsatisfied
Very Unsatisfied
Rate the courtesy and helpfulness of staff
Very Satisfied
Satisfied
Neutral
Unsatisfied
Very Unsatisfied
Rate the Cleanliness of clinic and toilet facilities
Very Satisfied
Satisfied
Neutral
Unsatisfied
Very Unsatisfied
Range of treatment options provided
Very Satisfied
Satisfied
Neutral
Unsatisfied
Very Unsatisfied
Rate our accessibility and parking facilities
Very Satisfied
Satisfied
Neutral
Unsatisfied
Very Unsatisfied
What is the likelihood that you will return for treatment
Definitely
Probably
Not Sure
Probably Not
Definitely Not
Please provide any further suggestions and comments
Anonymous entry?
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