Skip to Content

677 N New Ballas Road, Suite 207, Creve Coeur, MO 63141

Book Online
314-569-3141

Menu

About Us
- COVID-19 Safety Protocols
- Meet the Team
Services
Smile Gallery
Patient Information
Contact Us
Careers

Menu

About Us
- COVID-19 Safety Protocols
- Meet the Team
Services
Smile Gallery
Patient Information
Contact Us
Careers

Patient Feedback Survey

Patient Feedback Survey

At Creve Coeur Dental we are constantly trying to improve the services we deliver to you.
Please take a moment to rate each item.

Your Feedback is important to us and does help make our office a better place for our patients and staff.

First Name * Required
Last Name * Required
Email * Required

KEY: 1=Highly Dissatisfied, 5=Highly Satisfied
Additional comments are encouraged as we use them as a tool for achieving excellence.
Was it easy to schedule a convenient appointment? * Required
- 1
- 2
- 3
- 4
- 5
When you arrived at our office, were you greeted in a prompt and friendly manner? * Required
- 1
- 2
- 3
- 4
- 5
Were you seated and seen in a timely fashion? * Required
- 1
- 2
- 3
- 4
- 5
How satisfied were you with your hygienist and the dental cleaning performed? * Required
- 1
- 2
- 3
- 4
- 5
Was the dentist considerate and sensitive to your needs? * Required
- 1
- 2
- 3
- 4
- 5
How would you rate our explanation of patient financial obligations and responsibilities? * Required
- 1
- 2
- 3
- 4
- 5
How would you rate our administrative team’s customer service? * Required
- 1
- 2
- 3
- 4
- 5
How would you rate the cleanliness of the dental facility? * Required
- 1
- 2
- 3
- 4
- 5
How likely are you to return to our dental practice for future dental needs? * Required
- 1
- 2
- 3
- 4
- 5
How likely are you to refer a friend to our dental practice in the future? * Required
- 1
- 2
- 3
- 4
- 5
How friendly, understanding, and warm did you find the administrative team when making your appointment? * Required
- 1
- 2
- 3
- 4
- 5
How pleased were you with your dental assistant’s performance and communication skills during the visit? * Required
- 1
- 2
- 3
- 4
- 5
Who booked your appointment?
Who was your dental assistant?
Additional Comments
1 + 1 = * Required
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.

Back to the top

Home
About Us
Services
Smile Gallery
Patient Information
Contact Us
Careers

© 2024 Creve Coeur Dental. All Rights Reserved.

Privacy Policy
Sitemap