We are always striving to make your experience with Coburg Dental Group a positive one. We would love to hear your thoughts.
Your Email (for future contact purposes)
Approximately how long after your scheduled appointment time did you have to wait to be seen? I was seen at the scheduled timeI waited 5-10 minutesI waited 10-15 minutesI waited longer than 20 minutes
Were you given an explanation for the delay? Choose "Not applicable" if your scheduled time was met. Yes, and it was satisfactoryYes, and it was unsatisfactoryNoNot Applicable
How satisfied were you with the following? Please tick.
i.The friendliness/courtesy of the reception staff was: Very PoorPoorFairGoodVery Good
ii.The friendliness/courtesy of the dental assistant was: Very PoorPoorFairGoodVery Good
iii.The friendliness/courtesy of the dentist/hygienist was: Very PoorPoorFairGoodVery Good
iv.The punctuality of the dentist/hygienist was: Very PoorPoorFairGoodVery Good
v.The explanations of the dentist/hygienist about my problem/treatment was: Very PoorPoorFairGoodVery Good
vi.The amount of time the dentist/hygienist spends time with me was: Very PoorPoorFairGoodVery Good
vii.The instructions the dentist/hygienist gave me about my follow up care were: Very PoorPoorFairGoodVery Good
viii.The overall cleanliness/tidiness of the surgery was: Very PoorPoorFairGoodVery Good
ix.The cost of treatment in relation to the services provided was: Very PoorPoorFairGoodVery Good
x.Likelihood of me recommending Coburg Dental Group to others was Very PoorPoorFairGoodVery Good
How long have you been a patient with the practice? Less than a year1 to 2 years2 to 4 yearsMore than 4 years
What did you love most about your visit at the practice?
What improvements would you make to your visit?
Do you have any other comments you wish to make?
127 Sydney Road Coburg VIC 3058 E: email@example.com T: (03) 9386 1805 F: (03) 9384 1759
Monday 8:00am – 5:00pm Tuesday 8:00am – 8:00pm Wednesday 8:00am – 5:00pm Thursday 8:00am – 5:00pm Friday 8:00am – 5:00pm Saturday 8:30am – 5:00pm Sunday 9:00am – 4:00pm
© 2020 Coburg Dental Group.