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Supporting Dental Patients with Autism
This
New Jersey Dental Association Member Survey
was created In collaboration with
Autism New Jersey
, and should take 5 or 6 minutes to complete.
*
1.
What is your role in the dental practice?
(Required.)
Administrative support
Dental assistant
Dental hygienist
Practice owner / partner
Associate dentist
DSO-affiliated dentist
Locum tenens / temporary dentist
Other (please specify)
*
2.
Primary Practice Modality (select all that apply)
(Required.)
Solo private practice
Small group practice (2-5 dentists)
Medium group practice (6-20 dentists)
Large group practice (21+ dentists)
DSO-affiliated practice
Hospital / FQHC
Academic setting
Other (please specify)
*
3.
How many operatories does your practice have?
(Required.)
1-3
4-6
7-10
11+
*
4.
How many Full-Time Equivalent Dentists (FTE’s) are there in your practice?
(Required.)
1
2-3
4-6
7-10
11+
*
5.
How often do you treat patients with autism in your practice?
(Required.)
Regularly
Occasionally
Rarely
Never
