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Hello:
You are invited to participate in our Dental Insurance survey . In this survey, approximately 100 people will be asked to complete a survey that asks questions about dental visits as it relates to having insurance. It will take approximately ten minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential.
Thank you very much for your time and support. Please start with the survey now.
If yes, does your insurance cover dental visits?
Yes
No
What is your race?
African American
Caucasian
Asian
American Indian
Native Hawaiian
What is your gender?
Female
Male
Are you aware of how many times a year it is recommended to visit the dentist?
Yes
No
How often do you visit the dentist?
Once a year
Every 6 Months
Never
Do you suffer from tooth aches?
Yes
No
Do you visit the dentist for reasons other than major toothaches?
Yes
No
How often do you do screenings?
Once a year
Every 6 months
Never
Do you have insurance?
Yes
No
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