East Islip Dentist whose services include whitening, teeth cleaning, caps, bridges, fillings, cosmetic dentistry, hygienist, Bonding, Porcelain Veneers, Suffolk County

Please Complete our customer satisfaction survey

In order to provide our patients with the best dental services possible, we are taking an informal survey. We want to learn how well we are doing now and what we might do better from your point of view. Please answer the questions below, adding any comments you would like to share. The results of the survey are private and will be kept confidential.

1) How did you originally hear about Dr. Rosenfeld's dental practice?
	Recommendation of friend or family
	Name:
	Newspaper Advertisement
	Ad in Community Publication
	Verizon Yellow Pages
	Yellow Book

2) Was the reception area welcoming?
	YES
	NO
Comments:

3) Was your treatment performed on time?
	YES
	NO
Comments:

4) Was the staff caring and friendly?
	YES
	NO
Comments:

5) Did the dental care providers (dentist/hygienist/assistants) treat you as you wanted to be treated during your visit?
	YES
	NO
Comments:

6) Were your fears about dental procedures listened to, discussed and cared for?
	YES
	NO
Comments:

7) Were there any problems during your visit? If so, please describe them so we may address them:
	YES
	NO
Comments:

8) Were the layout, cleanliness and décor of the office pleasing to you?
	YES
	NO
Comments:

9) Were financial matters handled in a timely and appropriate manner?
	YES
	NO
Comments:

10) Would you recommend this practice to your family and friends?
	YES
	NO
Comments:

11) I would like more information about:
Comments:

12) Please provide your e-mail address if you would like us to respond personally to your concerns: