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Patient Survey

At Greenfield Dental Associates, we are always looking for ways we can improve our service and make your visit more pleasant. By taking a moment to fill out the survey below, you can help target the areas of service that are important to you.

General Questions

How did you enjoy your visit?

What would you have liked to change about your visit?

Did your dentist address your primary concerns? (please explain)

Was your visit pain-free and comfortable?
yes     no

Was your visit rushed?
yes     no

Would you refer your family and friends to Greenfield Dental Associates?
yes     no

 

Please rate the following on a scale of 1 through 5:
(1 = poor   5 = excellent)

The Office

Parking
1      2      3      4      5      NA

Furniture:
1      2      3      4      5      NA

Walls:
1      2      3      4      5      NA

Lighting:
1      2      3      4      5      NA

Size of office:
1      2      3      4      5      NA

Restrooms:
1      2      3      4      5      NA

 

Office Staff

Friendliness:
1      2      3      4      5      NA

Intelligence:
1      2      3      4      5      NA

Cared about your problem:
1      2      3      4      5      NA

Promptness:
1      2      3      4      5      NA

Personal Appearance:
1      2      3      4      5      NA

 

Operatory

Color:
1      2      3      4      5      NA

Decor:
1      2      3      4      5      NA

Scent:
1      2      3      4      5      NA

Dental Chair:
1      2      3      4      5      NA

Lighting:
1      2      3      4      5      NA

Noise:
1      2      3      4      5      NA

Equipment:
1      2      3      4      5      NA

Cleaniness:
1      2      3      4      5      NA

 

Your Dentist

Friendliness:
1      2      3      4      5      NA

Intelligence:
1      2      3      4      5      NA

Cared about your problem:
1      2      3      4      5      NA

Promptness:
1      2      3      4      5      NA

Personal Appearance:
1      2      3      4      5      NA

 

Dental Assistant

Friendliness:
1      2      3      4      5      NA

Intelligence:
1      2      3      4      5      NA

Cared about your problem:
1      2      3      4      5      NA

Promptness:
1      2      3      4      5      NA

Personal Appearance:
1      2      3      4      5      NA

 

Hygienist

Friendliness:
1      2      3      4      5      NA

Intelligence:
1      2      3      4      5      NA

Cared about your problem:
1      2      3      4      5      NA

Promptness:
1      2      3      4      5      NA

Personal Appearance:
1      2      3      4      5      NA

 

Your Experience

Understood treatment:
1      2      3      4      5      NA

Comfort during treatment:
1      2      3      4      5      NA

 

Your Bill

Knew cost before treatment:
1      2      3      4      5      NA

Payment terms understood:
1      2      3      4      5      NA

 

Additional Comments


Dr. Gene and Dr. Elliott



Contact Us: 126 High Street Greenfield, MA 01301 Phone: 413-774-2871