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patient satisfaction survey

thank you for your time!

We're interested in your complete satisfaction with our office staff, dental assistants and Dr. Sato. Please complete the following Patient Satisfaction Survey - you have the option of remaining anonymous. Thank you in advance for your time.

If you would like to be contacted by Dr. Sato regarding your comments, please include the following information:

Please rate your satisfaction with each of the following:
1=Very Satisfied; 2=Somewhat Satisfied, 3=Neutral, 4=Somewhat Dissatisfied, 5=Very Dissatisfied
Overall satisfaction with your Dental Office Experience:
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2
3
4
5
Telephone Communication:
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3
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5
Receiving a warm and sincere greeting upon arrival:
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5
Timeliness of check-in:
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3
4
5
Ability of staff to anticipate your needs:
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2
3
4
5
Cleanliness:
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2
3
4
5
Quality of care:
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2
3
4
5
Satisfaction with checkout:
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2
3
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5
Please rate your satisfaction with each of the following:
1=Very Satisfied; 2=Somewhat Satisfied, 3=Neutral, 4=Somewhat Dissatisfied, 5=Very Dissatisfied
How likely are you to recommend us to family or friends?
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2
3
4
5
Please rate your satisfaction with each of the following:
1=Very Satisfied; 2=Somewhat Satisfied, 3=Neutral, 4=Somewhat Dissatisfied, 5=Very Dissatisfied
If you reported any problems, how satisfied are you with the resolution?
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2
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5
Please suggest any advice, product or amenity you would like added, or please let us know which staff members have made your visit more memorable.
thanks again!
contact us today!
our address:
Steve A. Sato, DDS
1222 S. Patterson Blvd
Dayton, OH 45402

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