Dr. Robert H. Singelyn, DDS, PC
Advanced Cosmetic, Sedation & Family Dentistry 		2300 Haggerty Road
West Bloomfield MI 48323
Telephone 248-624-0008
Welcome Meet The Staff Office Tour Hours & Contact Office Location See Our Work Services & Procedures New Patient Information Ask The Doctor Patient Survey Patient Education Payment & Insurance
 
It is our greatest pleasure to have you as a patient. As you know, our practice is committed to 100% patient satisfaction. Because we are proud of all the beautiful smiles we have created in the community, we want you to be excited about all of the services we provide. As a practice fully committed to excellent customer service, we value your opinion. Our practice always welcomes your feedback on ways we can improve. We ask that you complete our customer service survey so that we can better meet your needs. Thank you for giving us the confidence of your care!
 
 Our People My Expectations Were
  Exceeded Met Not
Met 		Doesn't
Apply
 Were courteous on the phone
 Gave you a friendly greeting upon arrival
 Were helpful
 Provided explanations during/after treatment
 Looked professional in appearance
 
 Quality Care and Service My Expectations Were
  Exceeded Met Not
Met 		Doesn't
Apply
 Reception area and front desk
 Explanation of financial arrangement
 Care by the doctor
 Care by the dental team
 Overall care and service
 
 Our Office My Expectations Were
  Exceeded Met Not
Met 		Doesn't
Apply
 Scheduled appt. within reasonable time
 Delivered prompt service by the doctor
 Comfortable, clean reception area
 Overall office efficiency
 
 We'd Also Like To Know More About You  
  Male Female No
Response
 What is the gender of the patient?
  Patient Parent No
Response
 What is your relationship to this office?
  0-18 18-35 36-55 Over
55 		No
Response
 What is age group of the patient?
  1
Visit 		1-3
Months 		3-12
Months 		1
Year+ 		No
Response
 How long have you been coming to our office?
  Yes No Not
Sure 		No
Response
 Would you recommend our office to others?
 
 Miscellaneous  
 Did anyone provide outstanding service?  
 What do we need to improve?  
 Additional Comments?  
 
 If you would like to be contacted  
 Name  
 Telephone  
 

 
Welcome    Meet The Staff    Office Tour    Hours & Contact    Office Location
See Our Work    Services & Procedures    New Patient Information    Ask The Doctor
Patient Survey    Patient Education    Payment & Insurance   
© 2010
Dr. Robert H. Singelyn, DDS, PC     2300 Haggerty Road, West Bloomfield MI     248-624-0008