Mr Crocodile’s questionnaire
The questionnaire I am asking you to fill out is one of the measures aiming at obtaining information from our Patients, which will serve for planning pro-quality measures at the Own-Project Friendly Clinic Mr Crocodile. The questionnaire differs a little from those you know from other companies. Please carefully read its content and answer the questions in accordance with your opinion.
Thank you for your time devoted to filling out the questionnaire.
Regards
Clinic Owner
Joanna Rąpała, D.D.S.1.1 How do you assess the availability of benefits granted by the Clinic, understood as an easiness in arranging a convenient date of visit for you?
1 means unacceptable availability, 5 means very good availability.
| 1 | 2 | 3 | 4 | 5 |
1.2 How important is this feature for you?
1 means, that the availability for you is insignificant, 5 means, that it has key significance for your assessment of the Clinic’s services
| 1 | 2 | 3 | 4 | 5 |
2.1 How do you assess the conditions of the provided services?
1 means very low assessment, 5 means an excellent assessment
| 1 | 2 | 3 | 4 | 5 |
2.2 How important is this feature for you?
1 means, that the terms of providing benefits for you are insignificant, 5 means, that they have key significance for your assessment of services and the choice of our Clinic
| 1 | 2 | 3 | 4 | 5 |
3.1 How do you assess the atmosphere of providing services? Is it really as friendly as we declare?
1 means an unfriendly atmosphere, 5 means a friendly atmosphere, without objections
| 1 | 2 | 3 | 4 | 5 |
3.2 How important is the friendly atmosphere of providing dental services for you?
1 means insignificant, 5 means, that the atmosphere has key significance for your assessment
| 1 | 2 | 3 | 4 | 5 |
4.1 Please assess the dental personnel of services, which you have used at the Clinic, in terms of its courtesy and meeting your expectations..
1 means, that your expectations were not met, 5 means, that all your expectations were met
| 1 | 2 | 3 | 4 | 5 |
4.2 How important is it that the requirements imposed on the dentist by you are fulfilled during your visit at the Clinic?
1 means, that it is insignificant, 5 means, that it has key significance for your assessment
| 1 | 2 | 3 | 4 | 5 |
5.1 Please assess the intermediate personnel (assistants) of services, which you have used at the Clinic, in terms of its courtesy and meeting your expectations.
1 means, that your expectations were not met, 5 means, that all your expectations were met
| 1 | 2 | 3 | 4 | 5 |
5.2 How important is it that the requirements imposed on the dental assistant by you are fulfilled during your visit at the Clinic?
1 means, that it is insignificant, 5 means, that it has key significance for your assessment
| 1 | 2 | 3 | 4 | 5 |
6.1 Please assess the level of prices of services offered by the Clinic.
1 means very high prices, 5 means low prices
| 1 | 2 | 3 | 4 | 5 |
6.2 How important is the level of prices for you in choosing a clinic, which you shall attend?
1 means that the level of prices is insignificant, 5 means, that the prices have key significance
| 1 | 2 | 3 | 4 | 5 |