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Hello:
You are invited to participate in our survey [testing for erp]. In this survey, approximately (only you) people will be asked to complete a survey that asks questions about [your satisfaction with this software]. It will take approximately [5] minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

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Types of practice
 
Government
 
Private
 
Army
 
Universities(Teaching)
 
Other
 
 
 
 
Specialization
 
Paediatrics
 
Oral & Maxillofacial
 
Endodontics
 
Restorative
 
Periodontic
 
General Practitioner
 
Other
 
 
 
 
Nitrous oxide oxygen sedation used in practice
 
Yes
 
No
 
 
 
If no, reasons of not practicing nitrous oxide oxygen sedation (you may choose more than 1 answer)
 
Does not have equipment
 
No special training
 
Have equipment, but not confidence to use it
 
Does not have equipment and not confidence to use it
 
Patient preference
 
Other
 

 
 
How satisfied are you with nitrous oxide sedation
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
 
 
 
 
Do you find nitrous oxide oxygen sedation easy to use
 
Yes
 
No
 
 
My patient become very cooperative after being sedated with nitrous oxide
Strongly disagree Neither disagree nor agree Strongly agree
 
 
 
 
Have you ever counter any emergency sedation while using this type of sedation?
 
Yes
 
No
 
 
 
If yes, what kind of emergency situation
   
 
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