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Patient Survey

Ireland Park Dentistry Patient Survey - Dental Office Questionnaire

We appreciate all forms of feedback, so that we are able to understand and better serve our patients. If you would please take a moment to fill out this survey we would greatly appreciate it. Comments are sent directly to Dr. Meda. Thank you!

When you telephoned our office to make an appointment, was our staff member courteous and helpful in finding a suitable time?

Upon arriving at our office, were you greeted in a friendly manner and made to feel comfortable?

Were you seated by your appointment time or advised of any delays?

Did our staff member listen to and understand your concerns?

Did our staff members take the time to adequately explain your treatment plan and answer any questions you may have had?

Did our staff member take the time to explain your treatment plan and how your dental insurance would cover it? (please skip if you do not have dental insurance)

Did our staff members discuss your payment options in order to make your dental treatment more affordable to you?

During your visit to our office, do you feel that the staff members were concerned about your overall well being as a person, and not just your dental treatment?

Did the cleanliness of the office as well as the infection control meet your expectations?

Would you recommend our practice to your family and friends?

If you answered YES to ANY of these questions, there are often several alternatives to improve your teeth and smile. To receive a personalized response to your smile analysis, please complete the following form.

You can have the smile you’ve always wanted! To schedule a FREE, no obligation office consultation, contact us today to schedule an appointment.

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Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

Office Location

  • South Bend
  • 1902 East Ireland Road
  • South Bend, Indiana
  • 46614
  • Map & Directions
  • Call: (574) 291-8022
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