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CDS Member Satisfaction Survey

Member Satisfaction Survey

In order to provide continuous quality care for all our members, we would appreciate your evaluation of your CDS dental office. Thank you in advance for your response.

You will be rating your dental office by using the following scale:

E = Excellent
S = Satisfactory
U = Unsatisfactory
N/A - Not applicable for this visit

If you would like to contact our Member Services Department about your experience, please call 1-800-764-5393. If you would like to file a complaint/grievance about your experience, you may use the grievance form or you may contact Member Services as well.

We truly value your opinion and look forward to hearing from you. Thank you.

CDS Member Services Department

Please tell us your HMO or Insurance Carrier *
Office Appearance E = Excellent S = Satisfactory U = Unsatisfactory N/A - Not applicable for this visit
Appointment Availability E = Excellent S = Satisfactory U = Unsatisfactory N/A - Not applicable for this visit
Courtesy of Staff E = Excellent S = Satisfactory U = Unsatisfactory N/A - Not applicable for this visit
Doctor's Treatment of Patient E = Excellent S = Satisfactory U = Unsatisfactory N/A - Not applicable for this visit
Explanation of Treatment Plan E = Excellent S = Satisfactory U = Unsatisfactory N/A - Not applicable for this visit
Promptness to be seated E = Excellent S = Satisfactory U = Unsatisfactory N/A - Not applicable for this visit
Promptness of treatment when seated E = Excellent S = Satisfactory U = Unsatisfactory N/A - Not applicable for this visit
Timeliness of your pre-authorization to see a specialist E = Excellent S = Satisfactory U = Unsatisfactory N/A - Not applicable for this visit
Specialist's Treatment of Patient E = Excellent S = Satisfactory U = Unsatisfactory N/A - Not applicable for this visit
Which Dentist/Office did you see? (City or office number) *
Did your treatment meet with your satisfaction? * E = Excellent S = Satisfactory U = Unsatisfactory N/A - Not applicable for this visit
How would you rate your doctor's professional attitude? * E = Excellent S = Satisfactory U = Unsatisfactory N/A - Not applicable for this visit
How would you rate the staff's professional attitude? * E = Excellent S = Satisfactory U = Unsatisfactory N/A - Not applicable for this visit
Would you be willing to refer a family member or friend to SmileCare? * Yes No
Has your DDS referred you to a specialist In the last 6 months * Yes No
If yes above, were you satisfied? * Yes No N/A
Comments
Email if you'd like us to contact you. *
Your first and last name
Daytime Phone
* These are required fields

This website is for SmileCare patients, ortho patients of all ages - family dentistry, children's dentistry and seniors' dentistry. Providing care in California, Nevada and Texas. We also accept employement applications online.