Your Opinion – Online Quality Assessment

Please help us improve by giving us your feedback!   Use the form below to provide your feedback regarding appointment, which clinic you were seen in and how we rate in each of the areas.  If you wish, please feel free to give us your name and/or patient chart number in the comments section, along with your comments. 

If you wish to submit a patient concern, please do so in writing using our Patient Concern Form so we may investigate, address and work with you to resolve your concern.  If you do not have a printer or do not wish to print the form, please send your concerns in an email to: .

Thank you very much!

Date of last appointment  
My student/resident/faculty effectively communicated any dental problems, treatment and consequences for me to make an informed decision regarding my treatment.
I have received professional and quality dental care at the School of Dentistry.  
I receive care in a timely manner (within 1 year of initial exam) at the School of Dentistry.  
I am treated in a courteous and respectful manner.
My personal health information is confidential at the School of Dentistry.  
The reason for my dental visit has been addressed while receiving care at the School of Dentistry.  
My student/resident/faculty is approachable and knowledgeable.  
The patient safety and cleanliness practices at the School of Dentistry provide a safe environment for dental care.  
Financial services are helpful in assisting with the management of my dental bills.  
I am informed of the cost of my treatment.  
The cost of my treatment is reasonable.  

If you wish to receive a response to your patient concern, please submit a Patient Concern Form in writing. If you do not have a printer or do not wish to print the form, please ask for the form at your next appointment, or send an email to .