Professional Documents
Culture Documents
QUESTIONNAIRE
1) DEMOGRAPHIC DETAILS
ACADEMIC LEVEL
1. BACHELORS
2. MASTERS
1. 0-10
2. 11-20
3. ABOVE 20
1. < 20
2. <50
3. >50
1. ALL PATIENTS
2. UPON PATIENTS REQUEST
3. PEDIATRIC PATIENT
4. ANXIOUS AND FEARFUL PATIENT
5. DEPENDING UPON THE DENTAL CONDITION
4) DO YOU REFER PATIENTS TO ANY OTHER HEALTH CARE PROVIDER FOR ANAESTHETIC
ADMINSTERATION
1. YES
2. NO
1. ORAL
2. INTRA MUSCULAR
3. INTRA VENOUS
4. INHALATIONAL
5. COMBINATION OF ANY OF THE ABOVE
6. ANY OTHER MENTION ……………………
1. YES
2. NO
6) CHOOSE THE CORRECT OPTION REGARDING THE NEWER TECHNIQUES OF DELIVERY OF
LOCAL ANESTHESIA
6B. IF KNOWN BUT NOT USING, MENTION THE REASON FOR NOT USING THE ABOVE
AMELIORATIONS
1. EXPENSIVE
2. EFFECTIVENESS
3. AVAILABILITY
4. DIFFICULT TO USE
1. YES
2. NO