We’d Love To Hear From You

Patient Feedback

Q1 Dental Care is a private dental practice owned by Principal Dentist, Dr. Susan Leonera-Salazar. We are committed to provide on-going quality dental health care in the years to come. We value our relationship with our patients and we look forward to hear what you have to say about our practice, our staff and our services. We would appreciate you taking the time to complete our survey. All information contained in this survey will be kept strictly confidential.

Your Name :
Date :
Please rate and choose your answers from Poor (1) to Excellent (5)
When making an appointment, the telephone was answered promptly and politely.
 1 2 3 4 5
Was your appointment confirmed in the 24 hours prior to your visit?
 1 2 3 4 5
Was it easy to find the Q1 Dental Care clinic?
 1 2 3 4 5
How was the appearance of the Waiting/Reception area?
 1 2 3 4 5
On your arrival, were you met promptly and politely by the reception staff?
 1 2 3 4 5
How would you rate the level of professionalism of the reception staff?
 1 2 3 4 5
How was the cleanliness/appearance of the Q1 Dental Care room?
 1 2 3 4 5
Was the procedure clearly explained before any treatment?
 1 2 3 4 5
Were the fees/payment options clearly explained before any treatment?
 1 2 3 4 5
Were any questions or concerns raised by you satisfactorily addressed by the dentist or dental support staff?
 1 2 3 4 5
How would you rate the level of professionalism of the dentist and the dental staff?
 1 2 3 4 5
How would you rate your overall experience with Q1 Dental Care.
 1 2 3 4 5
Please add any comments or suggestions you may have:

 

Please feel free to download the Patient Feedback Form and mail completed form to Q1 Dental Care at Part Suite 1, 1st Floor, 23 Antill St. Queanbeyan, NSW 2620.