We want to provide you with the very best possible personal care and service that meets your needs. To do this, it is important that we know your views on the practice and the care we provide and to record your opinions on where we can improve.

How did you hear about the practice?
Passing the door
Yellow Pages
Other directory
Practice leaflet
NHS Direct
Other means
1. Have you been respected, involved and told what's happening at every stage?
Have you been involved in discussions about your dental care and treatment with your dentist and support staff?
Yes / No
Have you had support if you have needed help in making decisions and have staff respected your privacy and dignity?
Yes / No
Before you received any treatment were you asked whether or not you agreed to it?
Yes / No
2. Have you received care, treatment and support that meets your needs?
Do you feel that your personal needs were assessed to make sure you get safe and appropriate care that supports your rights?
Yes / No
Do you believe that you got the care that you and your dentist agreed would make a difference to your dental health and wellbeing?
Yes / No
Where appropriate, before and after your dental care or treatment you were advised what is best for you to eat and drink to meet your dental health needs?
Yes / No
Do you feel staff respected your cultural background, sex (gender), age, sexuality (whether you are lesbian, gay, bisexual or heterosexual person), religion or belief, and your disability if you have one?
Yes / No
3. You can expect to be safe
Did you feel that you were treated in a safe, clean and comfortable environment at the Practice?
Yes / No
4. You can expect to be cared for by staff with the right skills to do their jobs properly
Do you believe that your dental health and welfare needs were met by staff who are properly qualified?
Yes / No
Were there enough members of staff available to keep you safe and meet your needs?
Yes / No
5. You can expect your dental practice to routinely check the quality of its services
Do you believe your personal records are accurate and kept safe and confidential at all times at the practice?
Yes / No
Do you feel that if you complain it will be listened to and be dealt with properly?
Yes / No
What attracts you most about the practice?
What do you like least about the practice?
Would you recommend the practice to others?
Yes / No

Please tell us why
Math Result
Thank you very much for sparing the time for this survey.

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