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Survey

Patient Survey

We appreciate you taking the time to complete our satisfaction survey regarding your last visit to Roca Dental. Any comments you choose to leave will be kept strictly confidential and are used only to help us serve you better.

Which Doctor served you today?
Dr. Aurelio A. RocaDr. Adam J. Roca
What procedue did you have done?
Cleaning/CheckupFillingsCrownRoot CanalOther
How would you rate your overall visit?
ExcellentVery GoodAverageNot so good
When your appointment was over did you have a good understanding of your dental situation?
YesNot ReallyI wish i knew more about my situation
Were your financial options explained to you?
YesNoI already understand my financial options
Did you wait over 15 minutes past your appointment time to be seated? If yes, how long?
No15 minutes15-30 minutes30-45 minutesOver 45 minutes
Did the staff greet you promptly?
YesNot ReallyI don't recall
Would you refer your friends and family to us?
YesNoI'm not sure
What, if any improvements could we do to better your visit?

Any other comments/concerns regarding your visit?