Feedback
Type of Feedback
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Suggestion
Complaint
Compliment
General
This feedback is for
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Myself
Someone else
Your details
First Name
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Last Name
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Date of Birth
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Phone number
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Email Address
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Other persons details
First Name (Other person)
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Last Name (Other person)
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Date of Birth (Other person)
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Feedback details
Which dental clinic does your feedback relate to?
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Adelaide Dental Hospital (by referral only)
Angle Park (Parks)
Birkenhead (Le Fevre) (closed)
Bordertown
Ceduna (Contracted Private Dental Practice)
Clare
Coober Pedy (Contracted Private Dental Practice)
Elizabeth GP Plus
Evanston
Fulham Gardens
Gawler
Gilles Plains
Hendon
Kangaroo Island (Contracted Private Dental Practice)
Keith (Contracted Private Dental Practice)
Kingscote (Contracted Private Dental Practice)
Kingston SE (Contracted Private Dental Practice)
Linden Park
Magill
Marion GP Plus
Marleston
Millicent
Minlaton (Contracted Private Dental Practice)
Mitcham
Modbury GP Plus
Mount Barker
Mount Barker
Mount Gambier
Murray Bridge
Naracoorte
Noarlunga GP Plus
Pennington
Peterborough (Contracted Private Dental Practice)
Port Adelaide
Port Augusta
Port Lincoln
Port Pirie
Port Pirie West
Prospect
Riverland (Berri)
Roxby Downs (Contracted Private Dental Practice)
Salisbury
Victor Harbor
Wallaroo
Whyalla
Wudinna (Contracted Private Dental Practice)
Yorketown (Contracted Private Dental Practice)
What would you like to tell us?
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What action would you like taken?
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Have you discussed this matter with either a staff member at the dental clinic or the Clinic Manager?
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Yes
No
Would you like to be notified about the outcome or contacted if we need more information?
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Yes, I want to be contacted
No, I don't want to be contacted
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