Call us: (08) 9298 8187

Find Us: 4 Hardey Road Glen Forrest WA 6071

Email Us: info@gfdental.com.au

New Patient Form Feedback Form

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Patient Feedback

We value your feedback! Please take a couple of minutes to fill out our patient feedback form. All feedback received is handled in the strictest of confidence.

1. Was this your first visit to Glen Forrest Dental Care?*
- Yes
- No
How did you hear about us?

2. Did you have any difficulty locating us?*
- Yes
- No
Please tell us why:

3. How would you rate the reception you received on arrival?*
- Excellent
- Great
- Normal
- Bad
Please tell us why:

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4. Please rate your experience when calling to make an appointment or enquiry*
- Excellent
- Great
- Normal
- Bad
Please tell us why:

5. How punctual was the practice for your appointment?*
- On time
- ≥ 30 mins late
- 15-30 mins late

6. Which Dentist did you see?*
- Dr Lyndon Abreu
- Dr Anh Luong
- Dr Michael Khoury

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7. How well did you feel the Dentist and Dental Assistant worked together as a team?*
- Excellent
- Great
- Normal
- Bad
Please tell us why:

8. How clearly was treatment explained to you?*
- Very clearly
- Mostly clear
- Somewhat confusing
- Not clear at all
Please tell us why:

9. How would you rate the cleanliness and tidiness of the practice?*
- Excellent
- Great
- Normal
- Bad
Please tell us why:

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10. Would you refer your family and friends to the practice?*
- Yes
- No
Please tell us why:

11. Overall quality of care received during your visit?*
- Excellent
- Great
- Normal
- Bad
Please tell us why:

12. If you would like to be contacted further to discuss any of the feedback you have left above, please leave your contact details:
Phone
This field is for validation purposes and should be left unchanged.

Glen Forrest Dental Care is committed to providing customers with a comfortable service in a friendly, family orientated atmosphere.

Our expert team understand the importance of dental health and we strive to give our clients the dedicated treatment that they deserve.

If you want a winning smile, call Glen Forrest Dental Care today.

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