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1.If you had a choice, would you prefer to have:
 
a male dentist,
 
a female dentist,
 
the dentist with the most experience?
 
No prefrence
 
 
 
2.If you picked one, who happend not to be available would you be willing to:
 
wait longer to be seen by them
 
want the next available dentist
 
Look for another clinic
 
 
 
Is your prefrence affected by dentist's speciality?
 
Yes
 
No
 
Depending on the specialty
 
 
 
If your answer of the last question is depending on the speciality, which speciality is most?
 
Endo
 
Oral surgery
 
Perio
 
Other (mention): _____________
 
 
 
In case of emergency would you still insist on your dentist gender preference?
 
Yes
 
No
 
Not Sure
 
 
 
Is your dentist gender prefrence because of:
 
Religous values
 
Cultural values
 
Old experiences
 
Personal opinion
 
 
 
When you request a dentist appiontment, do you ask about his/her nationality?
 
Always
 
Sometimes
 
Never
 
Do not care
 
 
 
In case you always ask about the nationality of your dentist, depending on what?
 
Past own experiences
 
Advised by others, based on thier experiences
 
Just not convinced with the educational system in that country
 
Personal opinion
 
Other
 
 
 
 
If your answer is sometimes, depending on what?
 
The availability of your prefered nationality
 
The speciality you need
 
The age of the provider
 
The clinic reputation
 
Other
 
 
 
 
Would you give up you nationality prefrence in case of emergency?
 
Yes
 
No
 
Sometimes