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You are here: Home » Debond

Orthodontic department outcome measures

Clinician to complete

Please complete on day of debond
Consultant in charge of treatment(Required)
Is the consultant treating this patient?(Required)
If no, what is the grade of the clinician?
Presenting malocclusion(Required)
Class type(Required)
If multidisciplinary (select all that apply)
Appliance type (tick as many as required)(Required)
Treatment start date(Required)
Treatment end date(Required)
Transfer patient(Required)
If yes, what was the grade of the initial treating clinician?
Treatment completed as planned(Required)

Treatment evaluation: Patient to complete

This questionnaire asks for your views of the treatment that you have received. Your answers will be treated with the strictest confidentiality.
1. How would you rate your relationship with your orthodontist?(Required)
2. How satisfied are you with your teeth now?(Required)
3. How much do you think the problems with your teeth have improved?(Required)
4. How likely are you to recommend this department to your friends and family?(Required)

Patient diversity: patient to complete

The information you give us helps us understand if patients from across our community have different experiences. We use this information to help us to plan our services to best meet the needs of everyone.
Are you(Required)
Sex(Required)
Do you have physical or mental health conditions, disabilities or illnesses that have lasted or are expected to last for 12 months or more?(Required)
If yes, select all that apply
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