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Testimonials

Patient Survey
We appreciate you taking the time to complete our survey. Please feel free to comment on your visit as well. Any comments you choose to make are kept strictly confidential and can only help us become better in the future.

Patient name: Address City: Postcode: E-mail address:
How did you hear about the practice?
	Recommended  by friend/family
Name of friend/family :
	Referral by doctor
	Local
	Advertisement
	Phone book
	Website
	Other:  Please specify
Which dentist do you usually visit?
	Dr Sanjit Chaudhuri
	Dr Lorelei Garcia
	Dr Neda Zaman
	Dr Abid Abdulkhaliq
	Dr Helen Moss
	I don`t have a preferred dentist
How long have you been registered at the practice?
	I’ve recently joined the practice
	1-5 years
	More than 5 years
How long do you wait to be seen for your appointment?
	I’m usually seen on time
	15 minutes
	30 minutes
	Over 30 minutes
When you’re due for your check up, which of these methods would you prefer us to contact you via?
	Phone call
	Post
	Email
	Text
How would you rate the manner in which you were treated by the support staff?
	Excellent
	Very good
	Fair
	Unsatisfactory
My overall satisfaction with the dentist
	Excellent
	Very good
	Fair
	Unsatisfactory
How would you rate our services?
	Excellent
	Good
	Average
	Unsatisfactory
Would you refer your friends and family to us?
	Yes
	No
Please provide us with the contact details of anyone you wish to refer to our practice and we will do so on your behalf Name Address Contact telephone number
What do you like best about TLC Dental Surgery?
What would you suggest to better improve our service?
Please comment on how we could make your visit better, new services you would like to see, or other ways we can make you feel more comfortable.
Please enter the characters into the input box below