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Please write how much you agree with each of the questions below
N/A= Not appropriate, 1= Totally disagree, 2 = Part disagree, 3 = Neither agree nor disagree, 4 = Part agree, 5 = Fully agree

		1	2	3	4	5	N/A
1.	The information available to me (for example, in leaflets at reception) covers all that I need to know about using the practice’s services and looking after my dental care
2.	I’m usually able to book appointments at times that suit me
3.	When i have to pay for services, I believe the practice provides fair value for money
4.	It’s easy for me to enter and move around the building
5.	The reception, treatment room and other parts of the practice are always clean, comfortable and tidy
6.	Whenever I want to talk about anything privately I am able to do so in a quiet area
7.	I always feel well treated when I call to make an appointment or visit
8.	I have confidence in the knowledge and abilities of the dentists, hygienists and others involved in providing my dental care
9.	I’m always treated with dignity, gentleness and care by the dentist and others
10.	My opinion is always taken into account when my treatment options are being discussed and agreed

Overall rating for this dentist

I would recommend this practice to friends or family.

I would not recommend this practice.

How satisfied were you with the time you had to wait for an appointment?

Were you treated with dignity and respect by staff at the practice?

How satisfied were you that the dental practice involved you in decisions about your care?

How satisfied were you with the information given by the practice on the cost of your treatment?

How satisfied were you with the outcome of your treatment?

What I liked

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What could have been improved

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Any other comments

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Please summarise your overall experience in a single sentence

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Caring for Shoreham for over 80 years

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New patients

Painless care

Facial Aesthetics

STRAIGHT TEETH

Implants

New patients

Painless care

Facial Aesthetics

STRAIGHT TEETH

Implants