0%
Exit Survey
 
 
How long have you used our [PRODUCTS/SERVICES]?
 
Less than 6 months
 
6 months to less than 1 year
 
1 year to less than 3 years
 
3 years to less than 5 years
 
5 years or more
 
 
 
Which axiUm FORMS do you use? Select all that apply.
 
Health History
 
Dental History
 
Initial Assessment
 
CAMBRA
 
Screening
 
Consent to Treatment

 
 
 
How frequently do you purchase from us?
 
Every day
 
Every week
 
Every 2 - 3 weeks
 
Every month
 
Every 2 - 3 months
 
Every 4 - 6 months
 
Once or twice a year
 
 
 
How would you rate your level of satisfaction with axiUm dental software?
 
Highly satisfied
 
Somewhat satisfied
 
Neutral
 
Somewhat dissatisfied
 
Highly dissatisfied
 
 
How much do you rate clinic software on the following attributes?
Well Below Average Below Average Average Above Average Well Above Average
User Friendly
Form Content
Odontogram
Treatment Planning Module
Template Notes
Prescription Writing
miPACS
 
 
Comment:
   
 
 
 
How likely are you to continue doing business with us?
 
Very likely
 
Somewhat likely
 
Neutral
 
Somewhat unlikely
 
Very unlikely
 
 
 
How likely is it that you would recommend our [PRODUCTS/SERVICES] to a friend or colleague?
 
Very likely
 
Somewhat likely
 
Neutral
 
Somewhat unlikely
 
Very unlikely
 
 
 
Do you have any suggestions for improving our [PRODUCTS/SERVICES]?
   
 
 
 
What is your gender?
 
Male
 
Female
 
Prefer not to answer
 
 
 
Which category describes your age?
 
Younger than 18
 
18 - 24
 
25 - 34
 
35 - 44
 
45 - 54
 
55 - 64
 
65 or older
 
Prefer not to answer
 
 
 
What best describes your employment status?
 
Full time faculty
 
Adjunct faculty
 
Prefer not to answer
 
Other
 
 
 
 
Which of the following categories best describes the industry you work in?
 
Automotive
 
Advertising
 
Consulting Services
 
Education
 
Entertainment
 
Financial Services
 
Government Services
 
Healthcare
 
Human Resources
 
Information Technology
 
Marketing/Sales
 
Non-Profit
 
Pharmaceuticals
 
Public Relations
 
Technical Services
 
Travel
 
Other
 
 
 
 
Which category best describes your annual income?
 
Under $15,000
 
$15,000 - $29,999
 
$30,000 - $44,999
 
$45,000 - $59,999
 
$60,000 - $74,999
 
$75,000 - $89,999
 
$90,000 or more
 
Prefer not to answer