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PROMS Survey for Orthodontics (After)
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proms survey for braces after
Page Content
Patient-Reported Outcome Measures for Braces (After)
2 mins
estimated time to complete
Instructions
Thank you for choosing to have your treatment done at the National Dental Centre Singapore. As part of our efforts to continuously improve our service, we would like to find out about your experience with us.
Please answer the following questions by choosing the most relevant option on the scale.
Date of Visit
This is a required field.
Please enter a valid date.
Queue Ticket Number
This is a required field.
Please select only
one
response for each question. Thank you!
SECTION A. PATIENT REPORTED OUTCOME MEASURES
1. I am happy with the outcome of my orthodontic treatment.
Strongly Disagree
Disagree
Neutral
Agree
Strongly agree
This is a required field.
2. My facial/dental aesthetics has _______ after orthodontic treatment, as compared to before treatment.
Significantly worsened
Worsened
No change
Improved
Significantly improved
This is a required field.
3. My bite/chewing function has _______ after orthodontic treatment, as compared to before treatment.
Significantly worsened
Worsened
No change
Improved
Significantly improved
This is a required field.
4. My ease of brushing and maintaining oral hygiene has _______ after orthodontic treatment, as compared to before treatment.
Significantly worsened
Worsened
No change
Improved
Significantly improved
This is a required field.
5. My self-confidence has _______ after orthodontic treatment, as compared to before treatment.
Significantly worsened
Worsened
No change
Improved
Significantly improved
This is a required field.
SECTION B. PATIENT REPORTED EXPERIENCE MEASURES
1. In the course of your treatment, how often did the doctors:
a. Explain things in a way you could understand?
Never
Sometimes
Usually
Always
This is a required field.
b. Listen carefully to you?
Never
Sometimes
Usually
Always
This is a required field.
c. Treat you with courtesy and respect?
Never
Sometimes
Usually
Always
This is a required field.
d. Give you the opoportunity to ask questions or raise concerns?
Never
Sometimes
Usually
Always
This is a required field.
e. Address your dental concerns
Never
Sometimes
Usually
Always
This is a required field.
2. What is your overall experience?
Worse than expected
Slightly below expectation
Slightly above expectation
Better than expected
This is a required field.
3. Would you recommend NDCS to your family and friends, if they need similar treatment?
Definitely no
Probably no
Probably yes
Definitely yes
This is a required field.
4. Taking into account the treatment outcome and the cost of treatment, would you say the treatment was worth it?
Definitely no
Probably no
Probably yes
Definitely yes
This is a required field.
SECTION C. GENERAL FEEDBACK
1. If there is one area of improvement for the treatment, what would that be? Please provide the input in the box below.
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Name
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