Q1. In which area of Salford do you live?

Q2. In which age band are you?
16-18
19-24
25-34
35-44
45-54
55-64
65+

Q3. Do you have an NHS dentist in Salford?
Yes
No

If yes, is it local to where you live? If no, please go to Q10.

Q4. How often do you visit your dentist?

Q5. Does your dentist give you information on oral hygiene for example how often you should brush your teeth, the type of toothpaste to use etc.

Q6. Does your dentist have information in the surgery about the new pricing structure (three bands of charges Band 1 - £16.20, Band 2 - £44.60, Band 3 - £198, urgent treatment - £16.20)?
Yes
No

Q7. Do you understand the new pricing structure? What this includes and what you should be paying? For example, do you know if white fillings and white crowns are included in any of the price bands etc?
Yes
No

Please give details.

Q8. Do you feel that you have been incorrectly charged or treated by your dentist at any time?
Yes
No

If yes, please give further information.

Q9. Do you have any disabilities or special requirements that your dentist should consider?
Yes
No

If yes, has your dentist catered for these?

(please now go to Q14)

Q10. If you do not have a NHS dentist, do you have a private dentist?
Yes
No

Q11. Did you want a NHS dentist?
Yes
No

If yes, please give details why you do not have one, for example was your local NHS dentist full etc.

(If no, please go to the end of the questionnaire)

Q12. Did you ring a local NHS dentist?
Yes
No

If yes, and they were not accepting new NHS patients. Did they give you the following information?

Did they have a waiting list?
Yes
No

Were you put on the waiting list?
Yes
No

If yes, how long was the list for?

Were you given the telephone number of the Primary Care Trust to find your nearest dentist?
Yes
No

Did they give you the telephone number of another local dentist?
Yes
No

Q13. Do you know where your nearest NHS dentist is that is accepting new patients, please give details?

Q14. Are there any other comments you would like to make about NHS dentists in Salford or the new pricing structure?

Thank you for your time in completing this questionnaire.

If you would like a copy of this report when completed, or would like to be further involved in this or future pieces of scrutiny work, please complete the following. This information will be treated as confidential and not shared with any other parties.

Name

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