Q01
메시지
모든 템플릿
Oral Health Habits & Dental Care Experience Survey
Measures everyday brushing and flossing habits, common symptoms like gum bleeding or sensitivity, satisfaction with dental visits, and the real barriers keeping people from care. Built for dental practices, oral care brands, and public health researchers. An AI follow-up interview digs into the specific symptom or barrier each respondent flagged, uncovering the actual reasons behind it instead of a generic checkbox.
샘플 질문
템플릿에 포함된 내용을 미리 확인해 보세요. 모든 질문은 설문 공개 전에 자유롭게 수정할 수 있습니다.
질문 14개 · 약 7분
Q02
객관식필수
In the last 7 days, how often did you brush your teeth?
- Twice a day or more
- Once a day
- A few times this week
- Once this week or less
Q03
객관식필수
In the last 7 days, how often did you floss or use an interdental brush?
- Every day
- A few times
- Once
- Not at all
Q04
객관식필수
How long has it been since your last dental checkup or cleaning?
- Less than 6 months ago
- 6-12 months ago
- 1-2 years ago
- More than 2 years ago
- I've never been to a dentist
Q05
매트릭스필수
In the past 3 months, how often have you experienced each of the following?
4개 행 × 5개 열
- Bleeding or sore gums
- Tooth or gum sensitivity to hot/cold/sweet
- Bad breath you noticed yourself
- Tooth, jaw, or mouth pain
열: Never · Rarely (a few times) · Sometimes (monthly) · Often (weekly) · Almost every day
Q06
의견 척도필수
Overall, how satisfied are you with the current health of your teeth and gums?
척도: 1 – 7
최소:Very dissatisfied최대:Very satisfied
Q07
평점 척도
Thinking about your most recent dental visit, how would you rate the overall experience?
범위: 1 – 5
최소:Very poor최대:Excellent
Q08
객관식필수
What, if anything, keeps you from seeing a dentist as often as you think you should? Select all that apply.
- Cost of treatment
- Lack of dental insurance
- Fear or anxiety about dental visits
- Difficulty finding time
- Trouble finding a dentist I trust
- Bad past experience
Q09
AI 인터뷰
Probe into the respondent's most frequent or severe symptom from the earlier list (e.g., bleeding gums, sensitivity, pain) — ask when it started, whether it has changed recently, and what they've tried, if anything. Then connect it to their stated barriers to dental visits: understand whether cost, fear, time, or trust is the real blocker, and what would actually get them into a dentist's chair. If they selected 'no barriers,' ask what keeps their routine consistent instead.
Q10
의견 척도
If you currently have a regular dentist or dental provider, how likely are you to recommend them to a friend or family member?
척도: 0 – 10
최소:Not at all likely최대:Extremely likely
Q11
객관식
What is your age range?
- Under 18
- 18-24
- 25-34
- 35-44
- 45-54
- 55-64
- 65 or older
- Prefer not to say
Q12
객관식
What is your gender?
- Woman
- Man
- Non-binary
- Prefer not to say
Q13
드롭다운
Do you currently have dental insurance?
- Yes, private insurance
- Yes, public/government insurance
- No insurance
- Not sure
- Prefer not to say
Q14
메시지
Thank you for sharing your oral health habits and experiences! Your responses will be combined with others to help improve dental care access and everyday oral care guidance.
포함된 기능
AI 후속 질문
정형화된 설문이 놓치는 세부 내용을, 주관식 답변에 맞춰 AI가 심층 질문으로 끌어냅니다.
주의력 확인 장치
성의 없는 답변과 저품질 응답자를 걸러내는 내장 안전장치입니다.
AI가 작성한 문안
문구, 질문 순서, 분기 로직까지 AI가 연구 목표에 맞춰 작성합니다.
자동 리포트
응답이 모이면 주요 주제, 인용문, 이해하기 쉬운 요약이 자동으로 작성됩니다.
다른 서비스와 비교
다른 설문 도구의 가장 유사한 템플릿을 검토했습니다. 그 도구들이 잘하는 점과, 이 템플릿이 한발 더 나아가는 지점을 정리했습니다.
이 템플릿을 선택하는 이유
- Goes beyond frequency checkboxes by including an AI follow-up interview that probes the respondent's specific flagged symptom or barrier to uncover the real reason behind it
- Covers the full picture in one flow: brushing/flossing frequency, a symptom matrix (bleeding, sensitivity, etc.), last checkup timing, visit satisfaction and rating, and barriers to care
- Includes a loyalty-style opinion scale on likelihood to keep seeing their current provider, useful for practices and oral care brands tracking retention
- Built-in demographic and insurance-status questions let dental practices and public health researchers segment findings without extra custom fields
SurveySparrow
Oral Hygiene Survey TemplateA ready-to-field oral hygiene survey template covering habits and satisfaction, built on SurveySparrow's conversational form format. It's a static question set rather than an interview, so answers are limited to what's pre-written. Good for quick fielding but not for digging into why a respondent flagged a specific symptom or barrier.
잘하는 점
- Conversational, chat-style UI that can feel more engaging than a plain form
- Ready-to-use template requiring no build-from-scratch effort
- Part of a broader survey platform with reporting and distribution tools
아쉬운 점
- No adaptive follow-up questioning — every respondent sees the same fixed question set
- No mention of AI-driven probing into individual symptoms or barriers
- No published methodology or prompt transparency for how questions were designed
QuestionPro
Oral Health Survey Questions + Sample Questionnaire TemplateA sample questionnaire and question bank for oral health topics, positioned more as a reference guide with example questions than a single polished, ready-to-launch survey. Useful for researchers who want to build their own instrument, but it requires manual assembly and customization. No interview or follow-up capability is described.
잘하는 점
- Broad library of sample oral health questions to draw from
- Backed by an established survey platform with standard reporting features
- Flexible for researchers wanting to construct a custom questionnaire
아쉬운 점
- Reads as a question-bank/guide rather than a single fielding-ready template
- No adaptive or voice AI interview to explore individual respondent context
- No automated per-response quality scoring described
설문을 공개할 준비가 되셨나요?
이 템플릿을 편집기에서 열어 보세요. 첫 응답자가 보기 전에 모든 부분을 원하는 대로 바꿀 수 있습니다.