wondering if you guys could help me on this :)

My sister is working on her bachelor's degree and needs to have a survey completed on dental health. As many folks as I can get to fill out this survey would be appreciated.

After the survey if you could email it to toothladyjo@snet.net

Public Awareness of Dental Hygienists Survey


1) When was the last time you went to the dentist?

Less than 6 months ________
Less than 1 year___________
More than 1 year but less than 2 ___________
Over 2 year’s __________
Over 5 year’s __________

2) When was the last time you had your teeth cleaned?

Less than 6 months ___________
Less than 1 Year __________
More than 1 year but less than 2 years ___________
Over 2 year’s ___________
Over 5 year’s ___________

3) Who cleaned your teeth?

The dentist __________
The dental assistant _______
The dental hygienist _______
I am not sure_________

4) Do you know the difference between a dental assistant and a dental hygienist?

Yes________
No ________

5) What type of dental facility do you use for your dental care needs?
Private Office_________
Clinic_______
Hospital _____
School ______
Other_____

6) Is the person that cleaned your teeth licensed?

Yes ___
No____
I don’t know ___________


7) If you answered No to question 5 then, has the person graduated from an Accredited School?

Yes _____
No_____
I don’t know ________

Age:

18-25 ______
26-35_______
36-45_______
46-55_______
56 ________

9) Ethnicity

White______
African American _______
Asian ______
Hispanic_______
Native American________

10) How important do you feel the role of the dental hygienist is to your oral health?

Very important _________
Important__________
Somewhat important________
Not at all important________