Home Street Dental
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New Patient Survey
I am
Male
Female
Which provider did you see?
Dr. Harning
Jeannie
Linda
We answer the phone promptly and politely?
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Is it easy to make an appointment?
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
You received a friendly greeting on arrival?
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
We offer a comfortable and clean office setting?
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
We saw you on time?
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
We deliver prompt and professional service?
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
The doctor and staff are attentive to your needs and concerns?
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
We are compassionate and caring throughout your visit?
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
We thoroughly explained the financial arrangement?
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Overall, Home Street Dental has excellent services?
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I recommend the following improvement.
What did you like best about our office?
What did you like least about our office?
I will refer friends and family to this office?
Yes
No
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