NHS Oral Surgery Feedback We hope you were satisfied with the treatment received as part of the NHS Oral Surgery service. We strive to provide the best service possible and would be very grateful for your feedback. Name We would like you to think about your recent experience of our services. How likely are you to recommend our practice to friends and family if they needed similar care or treatment? * Extremely likely Likely Neither likely nor unlikely Unlikely Extremely unlikely Don't know Thinking of your response to this question, what is the main reason why you feel this way? How satisfied were you with; The length of time you had to wait for the appointment? Extremely Unsatisfied Unsatisfied Satisfied Extremely Satisfied Not Applicable Communication prior to the appointment? Extremely Unsatisfied Unsatisfied Satisfied Extremely Satisfied Not Applicable Cleanliness of the practice? Extremely Unsatisfied Unsatisfied Satisfied Extremely Satisfied Not Applicable Quality of treatment received? Extremely Unsatisfied Unsatisfied Satisfied Extremely Satisfied Not Applicable After-care, if needed? Extremely Unsatisfied Unsatisfied Satisfied Extremely Satisfied Not Applicable A little about you: Are you? Male Female What age are you? 0-15 16-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Do you consider yourself to have a disability? Yes No Which of the following best describes your ethnic background White British White Irish Other White Background Asian or British Asian - Indian Asian or British Asian - Pakistani Asian or British Asian - Bangladeshi Asian or British Asian - Chinese Other Asian Background Black Caribbean Black African Other Black Background White and Black Caribbean White and Black African White and Asian Other Mixed Background Anything Else I would rather not say Are you? the patient the parent or carer the patient and parent/carer If you DO NOT wish your anonymous comments to be shared then please tick here:
