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Zyris Clinical Feedback Participation
1.
Are you interested in participating in clinical feedback of Zyris new product ideas or product enhancements? We hope so!
Yes
No
2.
What is your role?
Dental Assistant
Extended Function Dental Assistant
Dentist
Hygienist
Speciality:
3.
List all that apply to your office
General Dentistry
Cosmetic Dentistry
Pediatric Dentistry
Orthodontics
Implant Surgery
Periodontics
Prosthodontics
Dental School
Other (please specify)
4.
Do you currently use an Isolation System? (check all that apply)
Isolite 3
Isolite Pro
Isolite 2
Isodry
Isovac (your version could be white instead of grey)
Isolite Core
Dry Shield
Mr Thirsty
Releaf for Hygiene
Kona Adapter
EZ Dam by Synca
Other
5.
What Isolation mouthpieces do you use? (check all that apply)
Isolite Posterior Mouthpieces
Isoliate Anterior Mouthpieces
DryShield Autoclavable Mouthpieces
DryShield Single Use Mouthpieces
Mr. Thristy
Releaf (hygiene)
Synca EZ Dam
Other (please specify)
6.
What size mouthpieces to do order regularly?
Large
Medium DV
Medium
Small
Extra Small
Pediatric
7.
Do you currently use Isolite Anterior Mouthpieces?
Yes
No
8.
Do you currently use our Isolite Retractor?
Yes
No
I did not know about it.
9.
Do you currently use Optragate retraction?
Yes
No
No i use another kind of retractor (please specify)
10.
Where would parts for the evaluations be sent to?
Attn:
Practice Name:
Address:
City:
State:
Zip Code
Customer ID (if you know it)
Best Email to contact you at:
11.
What is the name of the person in your office who usually fills out the surveys? (In some cases, I have had problems connecting survey responses to the clinicians who are doing the evaluation and this information might help ;)
12.
Please feel free to provide any current product feedback also.
Current Progress,
0 of 12 answered