Bissan Medical Center | patient

Your Name (required)

Your Email (required)

Your Phone Number (required)

Date of Visit

I had prior

Appointment Walk-in

How Did you hear about us?

Did you find our working hours convenient for you?

Did you find our parking convenient?

Upon entering our clinic, were you properly greeted and acknowledged by our staff?

Did the waiting area look clean and orderly?

How long did you wait before being seen by the dentist?

Was the receptionist helpful, polite and pleasant?

Was the dental assistant(s) friendly, supportive and confidant?

Was the dentist friendly, confident and supportive?

Did the dentist explain your treatment, answer your questions, and listen to you concerns?

Did the clinic chamber seem clean and hygienic?

The Level of the treatment I received was?

How would you rate the over all quality of Service you received at Bissan Dental Center?

Would you recommend us to your family, friend and co-workers?

Additional comments and Suggestions

If this is a complaint, do you wish to be contacted for follow-up?

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