Please fill out and provide the following information so we have a better understanding of your background, preferences and area of interest in Implant Dentistry.
What services do you presently provide:
Surgical Services Single tooth implant placementFull arch implant placementExtractions and immediate implant placementGuided Survery
Prosthetic Services Single tooth implant crownsFull arch implant prostheticsFull arch implant prosthetics Cement RetainedFull arch implant prosthetics Screw RetainedFull arch implant prosthetics Hybrid DenturesFull arch implant prosthetics Zirconia Bridges
Do you have an intra oral scanner? YesNo
If yes what system or type is it?
What type of implant training programs have you attended?
If applicable how many implants have you placed in your career or per year?
What implant system do you use or have used?
Select all that apply Socket GraftingRidge SplittingLateral or Full Sinus GraftsChin or Ramus Block GraftsSinus Bumps
Please explain what experience you have with full arch cases
Do you use any of: PRGFPRPBio ActiveBone Modifiers
What questions have not been addressed if any?
Looking ahead what would you like to gain from your involvement with the Hands On Mentorship Program
Thank you for taking the time to provide me with this information. Your answers are for internal use only and will be kept confidential. Upon submission of this questionnaire, you will be entering a registered area of the site.