Dr. Mark L. Mangelson DDS, MS (Periodontist - Salt Lake City, Utah) << Patient Survey >>

Patient Experience Survey

We consider it an honor to serve you and to provide you with the best possible care. To assist us in our effort to continually improve, we would ask you to please respond to the following questions, your comments are appreciated as well. Your responses will enable us to better meet your needs and those of other patients. Thank you very much!!

Questions	Excellent	Good	Neutral	Fair	Poor
Were you favorably impressed with the overall care you received from our office?
Was the office clean?
Were the financial arrangements handled well?
Was Dr. Mangelson gentle and considerate of your needs?
Was the office staff gentle and considerate of your needs?
Were we on-time for your appointment?
Was the appointment time convenient for you?
Are our office hours convenient for your schedule?
Were all of your questions answered during the exam and/or periodontal therapy session?
My exam/periodontal therapy session was thorough and informative?
Do you have a clear understanding of your dental needs?
Are you more motivated to improve you personal oral hygiene?
Would you recommend our professional services to friends or family?

Is there anything that we can do to improve our service to you during your exams or periodontal therapy?

If yes, please state.

Additional comments and suggestions:

Unless you fill out the Optional Information section of this survey, all answers and comments will remain anonymous.

Optional Information
Name
Address
City, State, ZIP
Phone
E-mail Address

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