This feedback template includes 8 fields. Gather patient feedback after dental appointments to assess comfort, care quality, and overall practice satisfaction. Free to customize and use on ZenBuild.
Patient Name (text, optional)
How comfortable did you feel during your visit? (rating, required)
How would you rate the friendliness of our staff? (rating, required)
How clearly did your dentist explain the treatment? (rating, required)
How would you rate the cleanliness of our office? (rating, required)
Were you seen at your scheduled appointment time? (multiple choice, required) — options: Yes, on time, Slightly delayed (less than 10 min), Noticeably late (10-30 min), Very late (30+ min)
Would you recommend our practice to others? (multiple choice, required) — options: Yes, Maybe, No
Is there anything we could do better? (long text, optional)
