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ADHPL > Team Members > Dentist > General Implantology

General Implantology

Dentist

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General Implantology

Dr. William REIDY

Composite/resin restoration Cosmetic/Ceramic(CEREC)Dentist General Implantology Guided Full Mouth Implantology Gum Disease (Conventional)Gum Disease (Laser Assisted)Implants Over Denture Laser Dentistry Oral Surgery (General)Oral surgery(laser assisted)Preventative Care

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Feedback

1Intro

2General

3Service

4Experience

In line with our practice accreditation and ADHPL operational policies (SOP) and in compliance with the Australian Patient Healthcare Charter duly adopted by our practice, our staff and management must seek regular feedback from colleagues and patients and review and act upon that feedback where appropriate.

The purpose of this exercise is to provide our clinical and administrative staff with information about their work through the eyes of those they work with and treat, and is intended to help inform their further development.

Please select the box as appropriate and base your answers on your latest visit at our practice. If you change your mind just cross out your old response and make your new choice. Please answer all questions before submitting.

Please note: Your feedback may be used for internal staff training, coaching and quality improvements.

Date of survey: *

Location of Service Received: *

Myaree Clinic
Willagee Clinic

Are you: *

Female
Male

Are you mostly anxious/nervous when attending a dentist? *

YES
NO
Can’t Say

Is your Age: *

Under 15
15–20
21–40
40–60
60 or over

Your most recent service date: *

Approx. Time of Service: *

8 am – 10 am
10 am - 12 pm
12 pm – 2 pm
2 pm – 4 pm
4 pm – 6 pm

Approx. Duration of Service: *

Under 30 min
30-45 min
45-60 min
60-90 min
90-120 min
Over 120 min

Serving Dentist: *

Dr. Katherine LAU
Dr. Ramanjit KAUR
Dr. William REIDY

Serving Assistant: *

Amanda KAAS-RASMUSSEN
Puneet KAUR
Sediqa HASSANI

Your purpose of visit to dental practice today? (Please tick all the boxes that apply) *

Professional Consultation, Diagnostics and Radiographic Analysis
Further discussion of your treatment plan, related financials, quotations and health fund rebates
For a routine check-up and scale and clean
Because of an ongoing problem
For treatment as mutually discussed and consented by myself
Because of one or more dental/oral problems (such as tooth ache, chipped tooth, jaw ache,, abnormal growth/cysts, mouth guards, snoring and sleep problems, crooked or mal-aligned teeth, swollen/bleeding gums, stained teeth, accident, etc)

Other (please specify)

Your Serving Dental Practitioner

How good was your general dentist today at each of the following key performance attributes? (Please tick one box in each line)

Being polite and courteous *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Making you feel at ease at all times *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Listen to your views and concerns *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Review and discuss your medical history *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Examining your dental condition *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Explaining your condition to you *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Proposing treatment options and related costs *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Involving you in decisions about your treatment *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Seeking your informed consent prior to treatment *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Providing or arranging treatment for you *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Providing educational/instructional materials *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Handling of your confidential information *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Post-operative instructions and care *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Punctuality and Timeliness of Service *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Use of gloves, masks, barriers and sterilized instrument packs *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Hand Washing, disinfecting and hygiene *

Poor
Less than Satisfactory
Not satisfactory
Good
Very good
Can’t Say

Your Overall Experience at the practice:

Was this visit with your usual dentist at the practice? *

Yes
No
Can’t say

I am confident about this dentist’s ability to provide care *

Yes
No
Can’t say

I am confident about the other auxiliary staff’s ability to provide care *

Yes
No
Can’t say

I would be completely happy to see this dentist again *

Yes
No
Can’t say

I would be happy to recommend this dentist to others *

Yes
No
Can’t say

Overall, I am satisfied with the services received at the clinic *

Yes
No
Can’t say

I am happy to recommend my friends/relatives to this practice *

Yes
No
Can’t say

I wish to add other comments, concerns, service quality improvements or changes addressed to the practice management for their consideration.

Privacy *

I do not wish to remain anonymous as part of this survey and happy disclose my personal contact details
I wish to remain anonymous and prefer not to provide by personal contact details within this survey

Full Name : *

First

Middle

Last

Email Address : *

Declearation *

I declare that I have reviewed, understood and accept your company privacy statement prior to submitting this patient feedback – short survey.
I declare that, the information provided in this short-survey represents my true and fair feedback on the service provided by their service professionals on the day of the service.
I declare that, should I not be fully satisfied with the service delivery at the practice at any time, I would NOT hesitate to report my grievances/concerns and to have them appropriately resolved.

Name