{"id":27058,"date":"2026-10-03T15:30:01","date_gmt":"2026-10-03T15:30:01","guid":{"rendered":"https:\/\/beyazitdentalcenter.com\/?page_id=27058"},"modified":"2026-10-03T15:30:49","modified_gmt":"2026-10-03T15:30:49","slug":"patient-satisfaction-survey","status":"publish","type":"page","link":"https:\/\/beyazitdentalcenter.com\/bg\/patient-satisfaction-survey\/","title":{"rendered":"\u041f\u0440\u043e\u0443\u0447\u0432\u0430\u043d\u0435 \u0437\u0430 \u0443\u0434\u043e\u0432\u043b\u0435\u0442\u0432\u043e\u0440\u0435\u043d\u043e\u0441\u0442\u0442\u0430 \u043d\u0430 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u0438\u0442\u0435"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"27058\" class=\"elementor elementor-27058\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-37f7832 elementor-section-boxed elementor-section-height-default elementor-section-height-default sc_fly_static\" data-id=\"37f7832\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-extended\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-f4def6d sc_inner_width_none sc_content_align_inherit sc_layouts_column_icons_position_left sc_fly_static\" data-id=\"f4def6d\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3ea35ee sc_height_huge sc_fly_static elementor-widget elementor-widget-spacer\" data-id=\"3ea35ee\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e53de2e elementor-section-full_width elementor-section-stretched elementor-section-height-default elementor-section-height-default sc_fly_static\" data-id=\"e53de2e\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-extended\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-609ddcb sc_inner_width_none sc_content_align_inherit sc_layouts_column_icons_position_left sc_fly_static\" data-id=\"609ddcb\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-f688670 elementor-widget__width-inherit sc_fly_static elementor-widget elementor-widget-heading\" data-id=\"f688670\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">PATIENT SATISFACTION SURVEY<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-f6895e0 elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-height-default sc_fly_static\" data-id=\"f6895e0\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-extended\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4ddefc2 sc_inner_width_none sc_content_align_inherit sc_layouts_column_icons_position_left sc_fly_static\" data-id=\"4ddefc2\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0483580 sc_fly_static elementor-widget elementor-widget-spacer\" data-id=\"0483580\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0b49ccf sc_fly_static elementor-widget elementor-widget-html\" data-id=\"0b49ccf\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<!-- ===========================================================\nBEYAZIT DENTAL CENTER - PATIENT SATISFACTION SURVEY\n===========================================================\nUSAGE:\n1) Add an \"HTML\" widget in Elementor.\n2) Paste this ENTIRE code into the widget.\n3) Publish the page and submit the form once as a test.\n4) An activation email from FormSubmit will be sent to\n   info@beyazitdentalcenter.com. Click \"Activate Form\" \/ \"I Agree\".\n   This is a one-time step. After activation, future submissions\n   will be delivered automatically.\n=========================================================== -->\n\n<style>\n:root{\n  --survey-primary:#708e98;\n  --survey-primary-dark:#2f4f59;\n  --survey-primary-soft:#eef5f6;\n}\n\n.survey-wrapper{\n  max-width:1050px;\n  margin:0 auto;\n  padding:0 0 40px;\n  box-sizing:border-box;\n  color:#555d60;\n  font-family:inherit;\n  font-size:14px;\n  line-height:1.4;\n}\n\n.survey-wrapper *,\n.survey-wrapper *::before,\n.survey-wrapper *::after{\n  box-sizing:border-box;\n}\n\n.survey-wrapper p{\n  margin:0;\n  padding:0;\n}\n\n.survey-intro{\n  width:100%;\n  margin:0 0 22px;\n  padding:18px 22px;\n  background:var(--survey-primary-soft);\n  border-left:4px solid var(--survey-primary);\n}\n\n.survey-intro h2{\n  margin:0 0 7px;\n  color:var(--survey-primary-dark);\n  font-size:22px;\n  line-height:1.25;\n  font-weight:700;\n}\n\n.survey-intro p{\n  color:#58656a;\n  font-size:14px;\n  line-height:1.55;\n}\n\n.survey-section-title{\n  width:100%;\n  min-height:42px;\n  margin:22px 0 0;\n  padding:10px 14px;\n  display:flex;\n  align-items:center;\n  background:var(--survey-primary);\n  color:#fff;\n  font-size:15px;\n  font-weight:700;\n}\n\n\/* DEMOGRAPHICS *\/\n.survey-demographic{\n  width:100%;\n  border-left:1px solid #d9dfe2;\n  border-right:1px solid #d9dfe2;\n  border-bottom:1px solid #d9dfe2;\n}\n\n.survey-demo-row{\n  display:grid;\n  grid-template-columns:180px minmax(0,1fr) 180px minmax(0,1fr);\n  min-height:54px;\n  border-top:1px solid #d9dfe2;\n}\n\n.survey-demo-label{\n  display:flex;\n  align-items:center;\n  padding:10px 12px;\n  background:#f1f1f1;\n  border-right:1px solid #d9dfe2;\n  color:#596367;\n  font-size:11px;\n  font-weight:700;\n  text-transform:uppercase;\n}\n\n.survey-demo-field{\n  display:flex;\n  align-items:center;\n  min-width:0;\n  padding:7px 8px;\n  background:#fff;\n}\n\n.survey-demo-row > .survey-demo-label:nth-child(3){\n  border-left:1px solid #d9dfe2;\n}\n\n.survey-wrapper select,\n.survey-wrapper input[type=\"date\"],\n.survey-wrapper input[type=\"number\"],\n.survey-wrapper input[type=\"text\"],\n.survey-wrapper textarea,\n.survey-wrapper input[type=\"email\"]{\n  font-family:inherit;\n}\n\n.survey-wrapper select,\n.survey-wrapper input[type=\"date\"],\n.survey-wrapper input[type=\"number\"],\n.survey-wrapper input[type=\"text\"]{\n  width:100%;\n  height:40px;\n  padding:7px 10px;\n  border:1px solid #c8d0d4;\n  border-radius:2px;\n  background:#fff;\n  color:#596367;\n  font-size:13px;\n  outline:none;\n}\n\n.survey-wrapper select:focus,\n.survey-wrapper input:focus,\n.survey-wrapper textarea:focus{\n  border-color:var(--survey-primary);\n  outline:none;\n}\n\n\/* PATIENT \/ RELATIVE *\/\n.survey-radio-inline{\n  display:flex;\n  flex-wrap:wrap;\n  align-items:center;\n  gap:22px;\n}\n\n.survey-radio-inline label{\n  display:inline-flex;\n  align-items:center;\n  gap:7px;\n  color:#596367;\n  font-size:13px;\n  cursor:pointer;\n}\n\n\/* 4-OPTION QUESTION TABLE *\/\n.survey-table{\n  width:100%;\n  border-left:1px solid #d9dfe2;\n  border-right:1px solid #d9dfe2;\n  border-bottom:1px solid #d9dfe2;\n  background:#fff;\n}\n\n.survey-table-head{\n  display:grid;\n  grid-template-columns:minmax(0,1fr) repeat(4,100px);\n  min-height:42px;\n  background:#eeeeee;\n  border-bottom:1px solid #d9dfe2;\n}\n\n.survey-head-question{\n  display:flex;\n  align-items:center;\n  padding:8px 12px;\n  color:#646b6e;\n  font-size:12px;\n  font-weight:600;\n}\n\n.survey-option-head{\n  display:flex;\n  align-items:center;\n  justify-content:center;\n  padding:5px 4px;\n  border-left:1px solid #d9dfe2;\n  color:#646b6e;\n  font-size:11px;\n  line-height:1.2;\n  text-align:center;\n}\n\n.survey-question-row{\n  display:grid;\n  grid-template-columns:minmax(0,1fr) repeat(4,100px);\n  min-height:70px;\n  background:#fff;\n}\n\n.survey-question-row + .survey-question-row{\n  border-top:1px solid #d9dfe2;\n}\n\n.survey-question-text{\n  display:flex;\n  align-items:center;\n  gap:10px;\n  min-width:0;\n  padding:10px 12px;\n  color:#555e62;\n  font-size:13px;\n  line-height:1.4;\n}\n\n.q-num{\n  flex:0 0 25px;\n  width:25px;\n  height:25px;\n  display:inline-flex;\n  align-items:center;\n  justify-content:center;\n  border-radius:50%;\n  background:var(--survey-primary);\n  color:#fff;\n  font-size:11px;\n  font-weight:700;\n}\n\n.survey-option-cell{\n  display:flex;\n  align-items:center;\n  justify-content:center;\n  min-width:0;\n  border-left:1px solid #d9dfe2;\n  background:#fff;\n  min-height:70px;\n  padding:5px;\n  cursor:pointer;\n}\n\n.survey-option-cell:hover{\n  background:#f7fafa;\n}\n\n.survey-option-cell input[type=\"radio\"]{\n  position:absolute;\n  opacity:0;\n  width:0;\n  height:0;\n}\n\n.survey-option-cell span{\n  display:flex;\n  flex-direction:column;\n  align-items:center;\n  gap:6px;\n  font-size:11px;\n  line-height:1.2;\n  text-align:center;\n  color:#596367;\n  pointer-events:none;\n}\n\n.survey-option-cell .dot{\n  width:20px;\n  height:20px;\n  border:2px solid #c9cfd2;\n  border-radius:50%;\n  position:relative;\n  flex:none;\n}\n\n.survey-option-cell input[type=\"radio\"]:checked ~ span .dot{\n  border-color:var(--survey-primary);\n}\n\n.survey-option-cell input[type=\"radio\"]:checked ~ span .dot::after{\n  content:\"\";\n  position:absolute;\n  top:2px;\n  left:2px;\n  width:12px;\n  height:12px;\n  border-radius:50%;\n  background:var(--survey-primary);\n}\n\n.survey-option-cell input[type=\"radio\"]:checked ~ span{\n  color:var(--survey-primary-dark);\n  font-weight:600;\n}\n\n\/* TEXTAREA *\/\n.survey-textarea-row{\n  width:100%;\n  padding:12px;\n  border-left:1px solid #d9dfe2;\n  border-right:1px solid #d9dfe2;\n  border-bottom:1px solid #d9dfe2;\n  background:#fff;\n}\n\n.survey-textarea-title{\n  display:flex;\n  align-items:center;\n  gap:10px;\n  margin-bottom:10px;\n  color:#555e62;\n  font-size:13px;\n  line-height:1.4;\n}\n\n.survey-wrapper textarea{\n  display:block;\n  width:100%;\n  min-height:95px;\n  padding:10px 12px;\n  border:1px solid #c8d0d4;\n  border-radius:2px;\n  background:#fff;\n  color:#596367;\n  font-size:13px;\n  line-height:1.45;\n  resize:vertical;\n}\n\n\/* WIDE MATRICES *\/\n.survey-wide-question{\n  display:flex;\n  align-items:center;\n  gap:10px;\n  padding:10px 12px;\n  background:#fff;\n  border-left:1px solid #d9dfe2;\n  border-right:1px solid #d9dfe2;\n  color:#555e62;\n  font-size:13px;\n  line-height:1.4;\n}\n\n.survey-wide-wrap{\n  width:100%;\n  overflow-x:auto;\n  border-left:1px solid #d9dfe2;\n  border-right:1px solid #d9dfe2;\n  border-bottom:1px solid #d9dfe2;\n  background:#fff;\n}\n\n\/* 9 doctors *\/\n.survey-wide-table{\n  display:grid;\n}\n\n.survey-wide-table.cols-9{\n  grid-template-columns:220px repeat(9,88px);\n  min-width:1012px;\n}\n\n.survey-wide-table.cols-8{\n  grid-template-columns:260px repeat(8,94px);\n  min-width:960px;\n}\n\n.survey-wide-cell{\n  display:flex;\n  align-items:center;\n  justify-content:center;\n  min-height:82px;\n  padding:7px 4px;\n  border-right:1px solid #d9dfe2;\n  border-bottom:1px solid #d9dfe2;\n  color:#5d6669;\n  font-size:10px;\n  line-height:1.2;\n  text-align:center;\n}\n\n.survey-wide-head{\n  min-height:66px;\n  background:#eeeeee;\n  font-weight:600;\n}\n\n.survey-wide-corner{\n  justify-content:flex-start;\n  padding-left:12px;\n  text-align:left;\n  font-size:11px;\n  color:#646b6e;\n}\n\n.survey-wide-spacer{\n  border-right:1px solid #d9dfe2;\n  border-bottom:1px solid #d9dfe2;\n  min-height:82px;\n}\n\n.survey-wide-cell.option{\n  cursor:pointer;\n  position:relative;\n}\n\n.survey-wide-cell.option:hover{\n  background:#f7fafa;\n}\n\n.survey-wide-cell.option input[type=\"radio\"]{\n  position:absolute;\n  opacity:0;\n  width:0;\n  height:0;\n}\n\n.survey-wide-cell.option .dot{\n  width:16px;\n  height:16px;\n  border:2px solid #c9cfd2;\n  border-radius:50%;\n  position:relative;\n}\n\n.survey-wide-cell.option input[type=\"radio\"]:checked ~ .dot{\n  border-color:var(--survey-primary);\n}\n\n.survey-wide-cell.option input[type=\"radio\"]:checked ~ .dot::after{\n  content:\"\";\n  position:absolute;\n  top:1px;\n  left:1px;\n  width:8px;\n  height:8px;\n  border-radius:50%;\n  background:var(--survey-primary);\n}\n\n.survey-submit-row{\n  display:flex;\n  justify-content:flex-end;\n  margin-top:20px;\n  align-items:center;\n  gap:14px;\n}\n\n.survey-wrapper button[type=\"submit\"]{\n  min-width:130px;\n  height:44px;\n  padding:0 25px;\n  border:0;\n  border-radius:2px;\n  background:var(--survey-primary);\n  color:#fff;\n  font-family:inherit;\n  font-size:14px;\n  font-weight:600;\n  cursor:pointer;\n}\n\n.survey-wrapper button[type=\"submit\"]:hover{\n  background:var(--survey-primary-dark);\n}\n\n.survey-wrapper button[type=\"submit\"]:disabled{\n  opacity:.6;\n  cursor:default;\n}\n\n.survey-msg{\n  display:none;\n  margin:18px 0 0;\n  padding:14px 18px;\n  border-radius:2px;\n  border:1px solid var(--survey-primary);\n  background:var(--survey-primary-soft);\n  color:var(--survey-primary-dark);\n  font-size:13px;\n}\n\n.survey-msg.show{\n  display:block;\n}\n\n.survey-msg.error{\n  border-color:#b33b3b;\n  background:#fbeceb;\n  color:#8a2f2f;\n}\n\n\/* Honeypot anti-spam field *\/\n.survey-hp{\n  position:absolute;\n  left:-9999px;\n  top:-9999px;\n  opacity:0;\n  height:0;\n  width:0;\n}\n\n@media(max-width:767px){\n  .survey-wrapper{\n    padding:0 10px 30px;\n  }\n\n  .survey-demo-row{\n    grid-template-columns:115px minmax(0,1fr);\n    grid-template-areas:\n      \"label1 field1\"\n      \"label2 field2\";\n  }\n\n  .survey-demo-row > .survey-demo-label:nth-child(1){\n    grid-area:label1;\n  }\n\n  .survey-demo-row > .survey-demo-field:nth-child(2){\n    grid-area:field1;\n  }\n\n  .survey-demo-row > .survey-demo-label:nth-child(3){\n    grid-area:label2;\n    border-top:1px solid #d9dfe2;\n    border-left:0;\n  }\n\n  .survey-demo-row > .survey-demo-field:nth-child(4){\n    grid-area:field2;\n    border-top:1px solid #d9dfe2;\n  }\n\n  .survey-table{\n    overflow-x:auto;\n  }\n\n  .survey-table-head,\n  .survey-question-row{\n    min-width:680px;\n    grid-template-columns:minmax(0,1fr) repeat(4,90px);\n  }\n\n  .survey-wide-wrap{\n    overflow-x:auto;\n  }\n\n  .survey-submit-row{\n    justify-content:center;\n  }\n\n  .survey-wrapper button[type=\"submit\"]{\n    width:100%;\n    max-width:220px;\n  }\n}\n<\/style>\n\n<div class=\"survey-wrapper\">\n\n  <div class=\"survey-intro\">\n    <h2>Patient Satisfaction Survey<\/h2>\n    <p>Your feedback is very important to us. By completing this survey, you help us better understand your experience and continue improving the quality of our services. Your responses will be used solely for service improvement purposes.<\/p>\n  <\/div>\n\n  <form id=\"bdc-survey-form\" action=\"https:\/\/formsubmit.co\/info@beyazitdentalcenter.com\" method=\"POST\">\n\n    <!-- FormSubmit settings -->\n    <input type=\"hidden\" name=\"_subject\" value=\"New Patient Satisfaction Survey - Beyaz\u0131t Dental Center\">\n    <input type=\"hidden\" name=\"_template\" value=\"table\">\n    <input type=\"hidden\" name=\"_captcha\" value=\"false\">\n\n    <!-- Honeypot anti-spam -->\n    <input type=\"text\" name=\"_honey\" class=\"survey-hp\" tabindex=\"-1\" autocomplete=\"off\">\n\n    <h3 class=\"survey-section-title\">Patient Information<\/h3>\n\n    <div class=\"survey-demographic\">\n\n      <div class=\"survey-demo-row\">\n        <div class=\"survey-demo-label\">First Name*<\/div>\n        <div class=\"survey-demo-field\">\n          <input type=\"text\" name=\"First Name\" autocomplete=\"given-name\" required>\n        <\/div>\n\n        <div class=\"survey-demo-label\">Last Name*<\/div>\n        <div class=\"survey-demo-field\">\n          <input type=\"text\" name=\"Last Name\" autocomplete=\"family-name\" required>\n        <\/div>\n      <\/div>\n\n      <div class=\"survey-demo-row\">\n        <div class=\"survey-demo-label\">Gender*<\/div>\n        <div class=\"survey-demo-field\">\n          <select name=\"Gender\" required>\n            <option value=\"\">Select Gender<\/option>\n            <option>Female<\/option>\n            <option>Male<\/option>\n            <option>Prefer Not to Say<\/option>\n          <\/select>\n        <\/div>\n\n        <div class=\"survey-demo-label\">Education Level<\/div>\n        <div class=\"survey-demo-field\">\n          <select name=\"Education Level\">\n            <option value=\"\">Select Education Level<\/option>\n            <option>Primary School<\/option>\n            <option>Secondary School<\/option>\n            <option>High School<\/option>\n            <option>University<\/option>\n            <option>Master's \/ Doctorate<\/option>\n          <\/select>\n        <\/div>\n      <\/div>\n\n      <div class=\"survey-demo-row\">\n        <div class=\"survey-demo-label\">Age*<\/div>\n        <div class=\"survey-demo-field\">\n          <input type=\"number\" name=\"Age\" min=\"1\" max=\"120\" placeholder=\"Your age\" required>\n        <\/div>\n\n        <div class=\"survey-demo-label\">Treatment Department*<\/div>\n        <div class=\"survey-demo-field\">\n          <select name=\"Treatment Department\" required>\n            <option value=\"\">Select Department<\/option>\n            <option>General Dentistry<\/option>\n            <option>Orthodontics<\/option>\n            <option>Implantology<\/option>\n            <option>Oral and Maxillofacial Surgery<\/option>\n            <option>Paediatric Dentistry<\/option>\n            <option>Cosmetic Dentistry<\/option>\n            <option>Periodontology<\/option>\n          <\/select>\n        <\/div>\n      <\/div>\n\n      <div class=\"survey-demo-row\">\n        <div class=\"survey-demo-label\">Survey Completed By*<\/div>\n        <div class=\"survey-demo-field\" style=\"grid-column:2 \/ 5;\">\n          <div class=\"survey-radio-inline\">\n            <label>\n              <input type=\"radio\" name=\"Survey Completed By\" value=\"Patient\" required>\n              Patient\n            <\/label>\n            <label>\n              <input type=\"radio\" name=\"Survey Completed By\" value=\"Patient's Relative\">\n              Patient's Relative\n            <\/label>\n          <\/div>\n        <\/div>\n      <\/div>\n\n    <\/div>\n\n    <h3 class=\"survey-section-title\">General<\/h3>\n\n    <!-- QUESTION 1 -->\n    <div class=\"survey-table\">\n      <div class=\"survey-table-head\">\n        <div class=\"survey-head-question\">Question<\/div>\n        <div class=\"survey-option-head\">Very Easy<\/div>\n        <div class=\"survey-option-head\">Easy<\/div>\n        <div class=\"survey-option-head\">Difficult<\/div>\n        <div class=\"survey-option-head\">Very Difficult<\/div>\n      <\/div>\n\n      <div class=\"survey-question-row\">\n        <div class=\"survey-question-text\">\n          <span class=\"q-num\">1<\/span>\n          <span>How easy was the appointment booking process for you?*<\/span>\n        <\/div>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 1 - Appointment Booking\" value=\"Very Easy\" required>\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 1 - Appointment Booking\" value=\"Easy\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 1 - Appointment Booking\" value=\"Difficult\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 1 - Appointment Booking\" value=\"Very Difficult\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n      <\/div>\n    <\/div>\n\n    <!-- QUESTION 2 -->\n    <div class=\"survey-textarea-row\">\n      <div class=\"survey-textarea-title\">\n        <span class=\"q-num\">2<\/span>\n        <span>If you experienced any difficulty while booking your appointment, please tell us what happened.<\/span>\n      <\/div>\n      <textarea name=\"Question 2 - Booking Difficulty\" maxlength=\"500\" placeholder=\"Write your answer here...\"><\/textarea>\n    <\/div>\n\n    <!-- QUESTIONS 3-4 -->\n    <div class=\"survey-table\">\n      <div class=\"survey-table-head\">\n        <div class=\"survey-head-question\">Question<\/div>\n        <div class=\"survey-option-head\">Excellent<\/div>\n        <div class=\"survey-option-head\">Good<\/div>\n        <div class=\"survey-option-head\">Average<\/div>\n        <div class=\"survey-option-head\">Poor<\/div>\n      <\/div>\n\n      <div class=\"survey-question-row\">\n        <div class=\"survey-question-text\">\n          <span class=\"q-num\">3<\/span>\n          <span>How would you rate the attention and support provided by the dental assistant who accompanied you?*<\/span>\n        <\/div>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 3 - Dental Assistant\" value=\"Excellent\" required>\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 3 - Dental Assistant\" value=\"Good\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 3 - Dental Assistant\" value=\"Average\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 3 - Dental Assistant\" value=\"Poor\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n      <\/div>\n\n      <div class=\"survey-question-row\">\n        <div class=\"survey-question-text\">\n          <span class=\"q-num\">4<\/span>\n          <span>How would you rate the attitude, care and attention of our clinic staff?*<\/span>\n        <\/div>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 4 - Clinic Staff\" value=\"Excellent\" required>\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 4 - Clinic Staff\" value=\"Good\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 4 - Clinic Staff\" value=\"Average\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 4 - Clinic Staff\" value=\"Poor\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n      <\/div>\n    <\/div>\n\n    <!-- QUESTION 5 -->\n    <div class=\"survey-table\">\n      <div class=\"survey-table-head\">\n        <div class=\"survey-head-question\">Question<\/div>\n        <div class=\"survey-option-head\">Very Satisfied<\/div>\n        <div class=\"survey-option-head\">Satisfied<\/div>\n        <div class=\"survey-option-head\">Average<\/div>\n        <div class=\"survey-option-head\">Dissatisfied<\/div>\n      <\/div>\n\n      <div class=\"survey-question-row\">\n        <div class=\"survey-question-text\">\n          <span class=\"q-num\">5<\/span>\n          <span>How satisfied were you with the waiting time at our clinic?*<\/span>\n        <\/div>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 5 - Waiting Time\" value=\"Very Satisfied\" required>\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 5 - Waiting Time\" value=\"Satisfied\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 5 - Waiting Time\" value=\"Average\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 5 - Waiting Time\" value=\"Dissatisfied\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n      <\/div>\n    <\/div>\n\n    <!-- QUESTION 6 - DOCTOR -->\n    <div class=\"survey-wide-question\">\n      <span class=\"q-num\">6<\/span>\n      <span>Please select the dentist who treated you.*<\/span>\n    <\/div>\n\n    <div class=\"survey-wide-wrap\">\n      <div class=\"survey-wide-table cols-9\">\n\n        <div class=\"survey-wide-cell survey-wide-head survey-wide-corner\">Question<\/div>\n\n        <div class=\"survey-wide-cell survey-wide-head\">\n          Dt.<br>Murat<br>Beyaz\u0131t\n        <\/div>\n\n        <div class=\"survey-wide-cell survey-wide-head\">\n          Dt.<br>Fulya \u00c7ebi<br>Beyaz\u0131t\n        <\/div>\n\n        <div class=\"survey-wide-cell survey-wide-head\">\n          Sp. Dt.<br>Gizem \u00c7ebi<br>Mahraml\u0131\n        <\/div>\n\n        <div class=\"survey-wide-cell survey-wide-head\">\n          Prof. Dr.<br>Mehmet Ali<br>Erdem\n        <\/div>\n\n        <div class=\"survey-wide-cell survey-wide-head\">\n          Specialist Dt.<br>Alaaddin<br>Avc\u0131\n        <\/div>\n\n        <div class=\"survey-wide-cell survey-wide-head\">\n          Dt.<br>Hazal Arslan<br>Tiryaki\n        <\/div>\n\n        <div class=\"survey-wide-cell survey-wide-head\">\n          Specialist Dt.<br>Kemal Can<br>\u00c7al\u0131o\u011flu\n        <\/div>\n\n        <div class=\"survey-wide-cell survey-wide-head\">\n          Dt.<br>Eda Nur<br>Toprak\n        <\/div>\n\n        <div class=\"survey-wide-cell survey-wide-head\">\n          Dt.<br>G\u00fcl\u015fah<br>Duran\n        <\/div>\n\n        <div class=\"survey-wide-spacer\"><\/div>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 6 - Dentist\" value=\"Dt. Murat Beyaz\u0131t\" required>\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 6 - Dentist\" value=\"Dt. Fulya \u00c7ebi Beyaz\u0131t\">\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 6 - Dentist\" value=\"Sp. Dt. Gizem \u00c7ebi Mahraml\u0131\">\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 6 - Dentist\" value=\"Prof. Dr. Mehmet Ali Erdem\">\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 6 - Dentist\" value=\"Specialist Dt. Alaaddin Avc\u0131\">\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 6 - Dentist\" value=\"Dt. Hazal Arslan Tiryaki\">\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 6 - Dentist\" value=\"Specialist Dt. Kemal Can \u00c7al\u0131o\u011flu\">\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 6 - Dentist\" value=\"Dt. Eda Nur Toprak\">\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 6 - Dentist\" value=\"Dt. G\u00fcl\u015fah Duran\">\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n      <\/div>\n    <\/div>\n\n    <!-- QUESTION 7 -->\n    <div class=\"survey-table\">\n      <div class=\"survey-table-head\">\n        <div class=\"survey-head-question\">Question<\/div>\n        <div class=\"survey-option-head\">Excellent<\/div>\n        <div class=\"survey-option-head\">Good<\/div>\n        <div class=\"survey-option-head\">Average<\/div>\n        <div class=\"survey-option-head\">Poor<\/div>\n      <\/div>\n\n      <div class=\"survey-question-row\">\n        <div class=\"survey-question-text\">\n          <span class=\"q-num\">7<\/span>\n          <span>How would you rate your dentist's attention and the explanations provided in response to your questions?*<\/span>\n        <\/div>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 7 - Dentist Communication\" value=\"Excellent\" required>\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 7 - Dentist Communication\" value=\"Good\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 7 - Dentist Communication\" value=\"Average\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 7 - Dentist Communication\" value=\"Poor\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n      <\/div>\n    <\/div>\n\n    <!-- QUESTION 8 -->\n    <div class=\"survey-table\">\n      <div class=\"survey-table-head\">\n        <div class=\"survey-head-question\">Question<\/div>\n        <div class=\"survey-option-head\">Very Satisfied<\/div>\n        <div class=\"survey-option-head\">Satisfied<\/div>\n        <div class=\"survey-option-head\">Average<\/div>\n        <div class=\"survey-option-head\">Dissatisfied<\/div>\n      <\/div>\n\n      <div class=\"survey-question-row\">\n        <div class=\"survey-question-text\">\n          <span class=\"q-num\">8<\/span>\n          <span>Overall, how satisfied are you with your treatment experience?*<\/span>\n        <\/div>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 8 - Treatment Experience\" value=\"Very Satisfied\" required>\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 8 - Treatment Experience\" value=\"Satisfied\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 8 - Treatment Experience\" value=\"Average\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 8 - Treatment Experience\" value=\"Dissatisfied\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n      <\/div>\n    <\/div>\n\n    <!-- QUESTION 9 -->\n    <div class=\"survey-table\">\n      <div class=\"survey-table-head\">\n        <div class=\"survey-head-question\">Question<\/div>\n        <div class=\"survey-option-head\">Very Clean<\/div>\n        <div class=\"survey-option-head\">Clean<\/div>\n        <div class=\"survey-option-head\">Average<\/div>\n        <div class=\"survey-option-head\">Not Clean<\/div>\n      <\/div>\n\n      <div class=\"survey-question-row\">\n        <div class=\"survey-question-text\">\n          <span class=\"q-num\">9<\/span>\n          <span>How would you rate the cleanliness, organisation and overall environment of our clinic?*<\/span>\n        <\/div>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 9 - Clinic Environment\" value=\"Very Clean\" required>\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 9 - Clinic Environment\" value=\"Clean\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 9 - Clinic Environment\" value=\"Average\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 9 - Clinic Environment\" value=\"Not Clean\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n      <\/div>\n    <\/div>\n\n    <!-- QUESTION 10 -->\n    <div class=\"survey-table\">\n      <div class=\"survey-table-head\">\n        <div class=\"survey-head-question\">Question<\/div>\n        <div class=\"survey-option-head\">Definitely<\/div>\n        <div class=\"survey-option-head\">Yes<\/div>\n        <div class=\"survey-option-head\">Not Sure<\/div>\n        <div class=\"survey-option-head\">No<\/div>\n      <\/div>\n\n      <div class=\"survey-question-row\">\n        <div class=\"survey-question-text\">\n          <span class=\"q-num\">10<\/span>\n          <span>Would you recommend our clinic to your family and friends?*<\/span>\n        <\/div>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 10 - Recommendation\" value=\"Definitely\" required>\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 10 - Recommendation\" value=\"Yes\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 10 - Recommendation\" value=\"Not Sure\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n\n        <label class=\"survey-option-cell\">\n          <input type=\"radio\" name=\"Question 10 - Recommendation\" value=\"No\">\n          <span><span class=\"dot\"><\/span><\/span>\n        <\/label>\n      <\/div>\n    <\/div>\n\n    <!-- QUESTION 11 - DISCOVERY CHANNEL -->\n    <div class=\"survey-wide-question\">\n      <span class=\"q-num\">11<\/span>\n      <span>How did you hear about our clinic?*<\/span>\n    <\/div>\n\n    <div class=\"survey-wide-wrap\">\n      <div class=\"survey-wide-table cols-8\">\n\n        <div class=\"survey-wide-cell survey-wide-head survey-wide-corner\">Question<\/div>\n        <div class=\"survey-wide-cell survey-wide-head\">Google<br>Search<\/div>\n        <div class=\"survey-wide-cell survey-wide-head\">Artificial Intelligence<br>(ChatGPT \/ Gemini)<\/div>\n        <div class=\"survey-wide-cell survey-wide-head\">Instagram<\/div>\n        <div class=\"survey-wide-cell survey-wide-head\">Friend \/ Relative<br>Recommendation<\/div>\n        <div class=\"survey-wide-cell survey-wide-head\">Passing By<\/div>\n        <div class=\"survey-wide-cell survey-wide-head\">Brochure \/ Poster<\/div>\n        <div class=\"survey-wide-cell survey-wide-head\">Event \/ Fair<\/div>\n        <div class=\"survey-wide-cell survey-wide-head\">Other<\/div>\n\n        <div class=\"survey-wide-spacer\"><\/div>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 11 - How Did You Hear About Us\" value=\"Google Search\" required>\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 11 - How Did You Hear About Us\" value=\"Artificial Intelligence (ChatGPT \/ Gemini)\">\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 11 - How Did You Hear About Us\" value=\"Instagram\">\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 11 - How Did You Hear About Us\" value=\"Friend \/ Relative Recommendation\">\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 11 - How Did You Hear About Us\" value=\"Passing By\">\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 11 - How Did You Hear About Us\" value=\"Brochure \/ Poster\">\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 11 - How Did You Hear About Us\" value=\"Event \/ Fair\">\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n        <label class=\"survey-wide-cell option\">\n          <input type=\"radio\" name=\"Question 11 - How Did You Hear About Us\" value=\"Other\">\n          <span class=\"dot\"><\/span>\n        <\/label>\n\n      <\/div>\n    <\/div>\n\n    <!-- QUESTION 12 -->\n    <div class=\"survey-textarea-row\">\n      <div class=\"survey-textarea-title\">\n        <span class=\"q-num\">12<\/span>\n        <span>Is there anything else you would like to share with us about your experience at our clinic?<\/span>\n      <\/div>\n      <textarea name=\"Question 12 - Additional Feedback\" maxlength=\"500\" placeholder=\"Write your answer here...\"><\/textarea>\n    <\/div>\n\n    <div class=\"survey-submit-row\">\n      <button type=\"submit\">Submit<\/button>\n    <\/div>\n\n    <div class=\"survey-msg\" id=\"bdc-survey-msg\"><\/div>\n\n  <\/form>\n<\/div>\n\n<script>\n(function(){\n  var form = document.getElementById('bdc-survey-form');\n  var msg = document.getElementById('bdc-survey-msg');\n\n  if (!form || !msg) return;\n\n  form.addEventListener('submit', function(e){\n    e.preventDefault();\n\n    var btn = form.querySelector('button[type=\"submit\"]');\n\n    btn.disabled = true;\n    btn.textContent = 'Submitting...';\n\n    msg.className = 'survey-msg';\n    msg.textContent = '';\n\n    fetch('https:\/\/formsubmit.co\/ajax\/info@beyazitdentalcenter.com', {\n      method: 'POST',\n      headers: {\n        'Content-Type': 'application\/json',\n        'Accept': 'application\/json'\n      },\n      body: JSON.stringify(Object.fromEntries(new FormData(form)))\n    })\n    .then(function(res){\n      if (!res.ok) {\n        throw new Error('Form submission failed.');\n      }\n      return res.json();\n    })\n    .then(function(){\n      msg.textContent = 'Thank you for your feedback. Your responses help us continue improving the quality of our care and services.';\n      msg.classList.add('show');\n\n      form.reset();\n\n      btn.disabled = false;\n      btn.textContent = 'Submit';\n\n      msg.scrollIntoView({\n        behavior:'smooth',\n        block:'center'\n      });\n    })\n    .catch(function(){\n      msg.textContent = 'An error occurred while submitting the form. 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