Dental Anxiety Questionnaire

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Feeling Nervous About Your Visit?

At Jiva Dental, we understand that many people feel nervous about visiting the dentist. Our friendly, experienced team takes the time to listen to your concerns and tailor your care to suit your individual needs. Whether you need extra reassurance, a slower pace, or additional comfort options, we’re here to help.

Our aim is to make every visit calm, gentle, and positive so you can feel confident about your dental care and leave with a healthy, happy smile. Your comfort and peace of mind are always our top priorities.

By completing this short questionnaire, you’ll help us understand your concerns so we can tailor your care and ensure you feel comfortable every step of the way.

Let us know how we can make your experience relaxed, gentle, and stress-free.

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What are your concerns about visiting the dentist?

Along with the differing reasons for suffering dental anxiety, there are also varying levels of fear. We have broken this questionnaire into sections to help us find out which aspect of our care causes you the most anxiety. Please rate your level of anxiety from 0 – 5, with 5 indicating the highest level of fear.

Before my appointment

The treatment

The dental surgery

My relationship with the dental team

Other

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We love to see you smile!

Hear first-hand from our smiling patients’ experience with us.

I have been a patient of Jiva Dental in Kingston for a very long time, and the level of customer care I receive from Dr. Bob and the entire team has consistently been exceptional. From the moment you … Read More

Altin Lleshi

Always friendly and a calm atmosphere which is good for a nervous patient like me. Many visits over about 18 months as I needed a lot of work having not been to the dentist for quite a few years. Most… Read More

Charles Sparrow

I came to Jiva for a toothed extraction as this was the only place I could find that did sedation. I’m so glad I did, it was such a smooth experience and Dr Bob is extremely in-tune with his patients,… Read More

OMK

I’ve just finished my Invisalign treatment and couldn’t be happier with the results. Dr Bob and the entire team at Jiva Dental were amazing throughout the process. I’d been on the fence for year… Read More

Matthew Jewell

I have been a patient at Jiva Dental for well over a decade. I first chose Dr Bob as I was terrified of dentists/dental work and he seemed to specialise in nervous patients. I now refuse go anywhere e… Read More

Rebecca Ffrench

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