Patient Feedback Survey: Tell Us How We Did!

Fill out the patient feedback survey below to let our dentists, hygienists and staff know how your most recent experience at Alaska Avenue Dental Clinic went!

At Alaska Avenue Dental Clinic, our dentists and team are committed to creating positive dental care experiences for all our Fort St. John patients.

In order to do the best job possible and serve our patients well, patient feedback is vital.

Please fill out the survey form below to let us know how we did during your last appointment with us – tell us what we did well, what you think we could improve upon, and anything in between!

We appreciate your input and will take it into consideration as we work to improve our practice!

First Name: *

Last Name: *

Phone Number: *

Email Address: *

Age: *

What was the nature of your last appointment at our office? *

Dental Exam/Cleaning Restoration Procedure (filling, crown, bridge, etc.) Periodontal Procedure Surgical Procedure (implants, root canal, etc.) Cosmetic Procedure (whitening, veneers, etc.) Other

1. Convenience & Ease of Getting Care

How would you rate...

Your ability to get in touch with us (via phone or email) to book an appointment? *

Good Fair Poor N/A

Our office hours and availability? *

Good Fair Poor N/A

Our promptness in returning calls and emails? *

Good Fair Poor N/A

The amount of time you spent in our waiting room? *

Good Fair Poor N/A

2. Quality of Care

Did the dentist or hygienist take the time to listen to your concerns and answer your questions? *

Yes Somewhat No N/A

Did the dentist or hygienist adequately explain your procedure and/or recommended treatment? *

Yes Somewhat No N/A

Was the dental assistant friendly, helpful and professional? *

Yes Somewhat No N/A

Was the front desk staff friendly, helpful and professional? *

Yes Somewhat No N/A

3. Our Office

Was your payment and billing information adequately explained to you? *

Yes No N/A

Was the clinic neat and clean? *

Yes Somewhat No N/A

Was your privacy respected during your visit? *

Yes Somewhat No N/A

4. Your Comments

Do you have any questions or concerns not addressed above? If so, please note them here:

What did you like about our clinic? What did we do well?

What didn't you like about our clinic? How can we improve?

Would you book another appointment at Alaska Avenue Dental Clinic? *

Yes Not Sure No

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