International Patient Feedback and Satisfaction Survey

Dear Patient,

This survey has been prepared to evaluate your views on the services provided at our healthcare facility, measure patient satisfaction, and contribute to the improvement of our service processes.

Your responses will be used in evaluation and improvement activities.

1. General Information

1. How did you contact our healthcare facility? *

Direct applicationThrough an intermediary organisationBy contacting our healthcare facility directlyOther

If you selected Other, please specify:

2. Which healthcare services did you receive? *

Implant treatmentProsthetic treatment / Dental crownsOrthodonticsOral and maxillofacial surgeryRoot canal treatmentPeriodontal treatmentsOther

Other service:

3. Date of service *

4. Country of origin *

2. Service Satisfaction

Please rate the following statements based on your experience.

1 – Very Dissatisfied3 – Neutral5 – Very Satisfied

Satisfaction with the application and appointment process

12345

Satisfaction with patient admission procedures

12345

Satisfaction with staff communication

12345

Satisfaction with foreign-language communication support

12345

Satisfaction with the information provided about the treatment process

12345

Satisfaction with your communication with the dentist

12345

Satisfaction with the approach of the healthcare staff

12345

Satisfaction with the waiting and organisation process

12345

Satisfaction with the facility’s cleanliness and hygiene conditions

12345

Satisfaction with measures taken to protect your privacy

12345

Satisfaction with the information provided after treatment

12345

Overall satisfaction with the services you received

12345

3. Travel and Accommodation Services

Did you receive travel, transfer, or accommodation support as part of your healthcare service? *

YesNo

If yes, how satisfied were you with these services overall?

4. Feedback, Suggestions and Complaints

What type of message would you like to submit to our healthcare facility?

Appreciation / Positive feedbackSuggestionComplaintRequest for informationOther

Other message type:

What is your message about?

Appointment / ApplicationPatient admissionDentist / Treatment processHealthcare staffPatient coordinationForeign language / CommunicationWaiting timePost-treatment follow-upTravel / Transfer / AccommodationOther