*1.This survey is being conducted by Adler Weiner Research in order to determine your eligibility for a focus group or interview about which you have been contacted. At no point are your individual answers ever sold or shared with our clients (aggregate data or anonymized summaries of the overall survey information may possibly be shared with our clients, however). This survey serves solely as a means for screening. Once the project has been completed this data will be deleted.  For more information please see:
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I consent to Adler Weiner Research collecting, storing and processing my personal information for the purpose of determining my eligibility for this market research focus group or interview.

I understand and consent to the following: That should I be eligible for participation in this market research focus group or interview, my contact information (phone, email, and home address) may be shared with the client for purposes related only to this particular project and are not limited to: screening calls to further determine eligibility, sending of "homework" or pre-session assignments via email, allowing access to an online platform via email, or for in-home interviews conducted at your residence.

We’re reaching out on behalf of a major dental equipment and supplies manufacturer. We are organizing focus groups with dentists to gather their reactions to a new dental prototype. This will NOT be a sales presentation of the company’s products. The focus group will be hosted by an independent moderator who will guide the discussion. In the session you will have a chance to test out a prototype and provide your opinion and perspective on the product. The information collected will help the manufacturer gain a better understanding of the usability, value, and pricing of the product that will be only used for market research purposes.

*2.CONTACT INFO Please provide the following:(Required.)

Name *

Address *

Apt # if applicable

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

*3.Which of the following best describes your profession?(Required.)

General dentist

Pediatric dentist

Oral surgeon

Orthodontist

Prosthodontist

Other (please specify)

None of the above

*4.For how many years have you been practicing in your profession?(Required.)

*5.How would you classify your dental practice?(Required.)

Sole proprietorship

Group practice / partnership

Dental Service Organization (DSO)

Hospital, community clinic, or non-profit

University or educational setting

Other (please specify)

*6.Which of the following best describes your level of involvement in the purchase decision process when buying dental consumables or supplies for your organization?(Required.)

I make purchase decisions, or lead a committee that makes the purchase decision.

I have significant authority in the purchase decision process, but I am not the sole decision maker, nor do I lead a committee.

I evaluate dental products and have influence in purchase recommendations, but do not have the authority to make purchase decisions.

I have minimal or no involvement in the purchase decision process.

*7.How familiar are you with the price range your practice or organization pays for universal paste composites? I am:(Required.)

Fully aware of the price range

Mostly aware of the price range

Somewhat aware of the price range

Not at all aware of the price range

*8.Do you personally perform composite restorative treatments?(Required.)

Yes

No

*9.On average, approximately how many universal paste composite restorations do you perform per week? Would you say you perform:(Required.)

Fewer than 20

Between 20 and 40

More than 40

*10.When performing these restorations, what percentage of time do you use the following delivery device?(Required.)

Capsule or compule with a dispenser:

Syringe:

*11.Which of the following universal paste composite manufacturers do you use in your practice? Brands included are for example purposes and do not represent an exhaustive list.(Required.)

a. Dentsply Sirona (i.e. Ceram.X Spectra ST, TPH Spectra ST)

b. GC (i.e. G-aenial, Essentia, Gradia Direct)

c. Ivoclar Vivadent (i.e. Tetric, Heliomolar, IPS Empress Direct)

d. Kavo Kerr (i.e. SimpliShade, Herculite, SonicFill 3)

Heraeus Kulzer (i.e. Venus, Charisma)

Kuraray (i.e. Clearfil Majesty, AP-X)

Shofu (i.e. Beautifil)

3M/Solventum (i.e. Filtek)

Tokuyama (i.e. Omnichroma, Estelite)

Ultradent (i.e. Vit-l-escence, Mosaic, Transcend)

VOCO (i.e. GrandioSo, Admira Fusion, Amaris)

Other (please specify)

*12.What percentage of your patients fall into the following categories?(Required.)

Pediatric patients (under age 18):

Adult patients (18-65 years old):

Elderly patients (older than 65):

*13.What gender do you identify with?(Required.)

Male

Female

Non-Binary/Other

*14.What is your exact Age and DOB:(Required.)

Age:

DOB:

*15.Do you or have you worked as a paid consultant for any dental manufacturer, or are you considered a “Key Opinion Leader” (someone who is well known in your region for offering opinions about dental products and providing dental expertise)?(Required.)

Yes

No

Thank you so much for completing this survey and expressing your interest in this research opportunity.  We will review your answers and our recruitment team will contact you if you are a match for the project. 
Please note, you must be contacted and confirmed by a recruiter to participate; filling out this survey does not guarantee your participation.   Unfortunately, due to the volume of responses we receive, if you do not qualify or if the project is already full, you may not be contacted.