Supporting Dental Patients with Autism

This New Jersey Dental Association Member Survey was created In collaboration with Autism New Jersey, and should take 5 or 6 minutes to complete.

Question Title

1. What is your role in the dental practice? (Required.)

Administrative support

Dental assistant

Dental hygienist

Practice owner / partner

Associate dentist

DSO-affiliated dentist

Locum tenens / temporary dentist

Other (please specify)

Question Title

2. Primary Practice Modality (select all that apply) (Required.)

Solo private practice

Small group practice (2-5 dentists)

Medium group practice (6-20 dentists)

Large group practice (21+ dentists)

DSO-affiliated practice

Hospital / FQHC

Academic setting

Other (please specify)

Question Title

3. How many operatories does your practice have? (Required.)

1-3

4-6

7-10

11+

Question Title

4. How many Full-Time Equivalent Dentists (FTE’s) are there in your practice? (Required.)

2-3

4-6

7-10

11+

Question Title

5. How often do you treat patients with autism in your practice? (Required.)

Regularly

Occasionally

Rarely

Never

Supporting Dental Patients with Autism

Question Title

* 1. What is your role in the dental practice? (Required.)

Question Title

* 2. Primary Practice Modality (select all that apply) (Required.)

Question Title

* 3. How many operatories does your practice have? (Required.)

Question Title

* 4. How many Full-Time Equivalent Dentists (FTE’s) are there in your practice? (Required.)

Question Title

* 5. How often do you treat patients with autism in your practice? (Required.)

1. What is your role in the dental practice? (Required.)

2. Primary Practice Modality (select all that apply) (Required.)

3. How many operatories does your practice have? (Required.)

4. How many Full-Time Equivalent Dentists (FTE’s) are there in your practice? (Required.)

5. How often do you treat patients with autism in your practice? (Required.)