www.wisdomteeth.co.nz > Oral Surgery Information Site








   Post Surgery Evaluation/Feedback Form

 


If you've recently undergone surgery with us, please take the time to complete the following evaluation of our services.

 

When answering the following questions consider this,

"How good was Don Macalister at..."

(1=very poor, 6=very good)

Providing me with an appointment on a day and time that suited me?
1 2 3 4 5 6

Providing me with written information on the procedure before the appointment?
1 2 3 4 5 6

Providing me with explanations of my treatment during the consultation?
1 2 3 4 5 6

At listening to me, and answering my questions?
1 2 3 4 5 6

At putting me at ease and dealing with my fears and anxieties?
1 2 3 4 5 6

At providing help after hours (If you needed it)?
1 2 3 4 5 6

Please provide an overall rating of our service?
1 2 3 4 5 6

If you spoke to our office by phone, how would you rate the service you received?
1 2 3 4 5 6

"In regard to the procedure you had..."

Was it better than you anticipated?
Yes No        

Was it worse than you anticipated?
Yes No        

Would you recommend Don Macalister's service to others?
Yes No        

If you had the power to make any changes you wished, what would you do to improve the level of service with patients such as yourself?

 

If you would like an answer or response to an enquiry, please enter your name and email address below: (Optional)

 

First Name
Last Name
Email Address