Use of a Survey Questionnaire

The patient (a.k.a the client, or the customer) is a valuable information source for feedback to a dental practice on how to improve access to care and treatment services.  Use of a well-designed patient survey form can be an invaluable asset to the dentist and the dental staff to obtain meaningful information from the clientele of the practice including receiving kudos for a well-run dental practice.

A favorable survey should include the following features:

  • Concise questions that address the topics of concern to the practice.

  • Address only one issue per question to avoid confusing data.

  • Limit the number of questions to maximize the response rate.

  • Design a patient response scale that is simple, descriptive, and minimizes ambiguity.

  • Include essential instructions for completing the survey and returning it to the practice.

  • Provide space for patients to write comments at the end of the document.

  • Do not require patients to sign the survey or to identify themselves.

  • Do indicate the information provided will be managed in a confidential manner.


Page 3 of 11