This questionnaire gives you the opportunity to comment on how well the Dental Hygiene Program is preparing students for their careers in Dental Hygiene.

Please provide a rating for each entry level skill in the 14 categories below.

Scale:
4 Outstanding - almost never requires instruction/supervision
3 Good - occasionally requires instruction/supervision
2 Fair - requires frequent instruction/supervision
1 Poor - needs constant instruction/supervision
N/A - not applicable / not observed

* 1. Risk Assessment / Health History

  4 Outstanding 3 Good 2 Fair 1 Poor N/A
Select One

* 2. Intra/Extra Oral Examination

  4 Outstanding 3 Good 2 Fair 1 Poor N/A
Select One

* 3. Occlusal Assessment

  4 Outstanding 3 Good 2 Fair 1 Poor N/A
Select One

* 4. Periodontal Assessment

  4 Outstanding 3 Good 2 Fair 1 Poor N/A
Select One

* 5. Dental Charting

  4 Outstanding 3 Good 2 Fair 1 Poor N/A
Select One

* 6. Deposit Assessment

  4 Outstanding 3 Good 2 Fair 1 Poor N/A
Select One

* 7. Treatment Plan

  4 Outstanding 3 Good 2 Fair 1 Poor N/A
Select One

* 8. Patient Education

  4 Outstanding 3 Good 2 Fair 1 Poor N/A
Select One

* 9. Instrumentation

  4 Outstanding 3 Good 2 Fair 1 Poor N/A
Select One

* 10. Calculus Removal

  4 Outstanding 3 Good 2 Fair 1 Poor N/A
Select One

* 11. Polishing

  4 Outstanding 3 Good 2 Fair 1 Poor N/A
Select One

* 12. Fluoride Treatment

  4 Outstanding 3 Good 2 Fair 1 Poor N/A
Select One

* 13. Clinical Management / Quality Assurance

  4 Outstanding 3 Good 2 Fair 1 Poor N/A
Select One

* 14. Ethics and Professionalism

  4 Outstanding 3 Good 2 Fair 1 Poor N/A
Select One

15. Comment Section (if you wish to make additional remarks):

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