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Periodontal Dressing
By completing this survey, you give Pulpdent Corporation permission to use the information you provide below for quality assurance and compliance purposes.
1) How often do you personally use periodontal dressing?
0-2 times per day
2-5 times per day
More than 6 times per day
*
2) Which periodontal dressing do you use regularly? (Please select only one for this survey)
(Required.)
PerioCare Periodontal Dressing
Other (please specify)
*
3) How long have you been using this material?
(Required.)
0-1 year
1-3 years
More than 3 years
4) What do you like most about this product?
*
5) Please rate the characteristics of the material you chose
(Required.)
Excellent
Good
Fair
Poor
N/A
Retention
Excellent
Good
Fair
Poor
N/A
Handling
Excellent
Good
Fair
Poor
N/A
Setting Time
Excellent
Good
Fair
Poor
N/A
Taste
Excellent
Good
Fair
Poor
N/A
Strength
Excellent
Good
Fair
Poor
N/A
6) For any answer of fair or poor, please explain:
*
7) Have your patients experienced any negative issues such as allergic reaction, post-op sensitivity, or infection after use of this material?
(Required.)
No
Yes, please specify
If yes, please rate the severity of the issue
Temporary mild
Temporary moderate
Temporary severe
Required medical attention
8) How often have you had to replace a dressing done with this material?
0-10 times per year
11-20 times per year
More than 20 times per year
Comments:
*
Are you a dental healthcare provider?
(Required.)
Yes
No
*
I give Pulpdent consent to follow up in 6 months
(Required.)
Agree
Disagree
We ask that you provide your contact information so we may reach you if needed to ensure the safety of our products. Information will not be used for marketing e-mails or phone calls, apart from notifying eligibility parties for gift card giveaways.
Name
Company
Email Address
Phone Number