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Evaluation of the clinical effectiveness and safety of the FLOW-ART medical device

Dear Sir/Madam,


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to complete the following survey.

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Evaluation of the clinical effectiveness and safety of the FLOW-ART medical device

Please be informed that your data obtained as a result of previous contacts with ARKONA Laboratorium Farmakologii Stomatologicznej Grzegorz Kalbarczyk (hereinafter referred to as ARKONA) is stored in the ARKONA Contractor Database, which is the administrator of your personal data. Details regarding ARKONA's personal data protection policy are available at https://arkonadent.com/wp-content/uploads/2020/10/arkonadent.com-polityka-prywatnosci.pdf. If you would like to obtain detailed information about the rules and purposes of ARKONA's processing of your personal data, please contact us at the following e-mail address: polityka.prywatnosci@arkonadent.com or at the postal address Nasutów 99C, 21-025 Niemce, Poland.

Doctor's personal details, professional licence number

Please provide your first name, surname and professional licence number. Please be aware that your personal data will not be collected, processed or disseminated without your knowledge and consent. It will only be used to confirm that the survey has been completed by an authorised person.

Address of the dental clinic/ practice

Medical Representative's initials

If applicable
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Evaluation of the clinical effectiveness and safety of the FLOW-ART medical device

Since when have you been using the FLOW-ART medical device ?

Select one answer

How often do you use FLOW-ART in your practice?

Select one answer

Which FLOW-ART shades have you used in your practice?

Please indicate all the shades you have used at least once in your practice

For which clinical indications do you use the FLOW-ART medical device?

Please mark the indications for which you have used the product (you can mark any number of indications):

What other indications?*

How many patients on average can be treated with one syringe of FLOW-ART?

Please enter the number of patients

How would you assess the volume (2 g) of material in the FLOW-ART package?

Select one answer

How would you assess the clinical effectiveness of the FLOW-ART product in terms of the clinical indications listed in the Instructions for Use of the medical device?

1 – very low, 5– very high

Any other indications?*

If you use the FLOW-ART product for indications other than those mentioned above, please describe them below and provide a rating (on a scale of 1-5)

In your opinion, how many years does a filling made with FLOW-ART composite last in a patient's mouth?

How do you assess the durability of FLOW-ART in the patient’s mouth compared to other materials of this type?

Select one answer

What are the main factors, in your opinion, that most affect the durability of the material in the patient’s mouth?

Select up to 3 answer

How would you assess the following functional characteristics and features of FLOW-ART?

(1 – very low, 5 – very high)

How do you assess the consistency of FLOW-ART for the following clinical indications?

Select one answer in each line

How would you assess the information on the FLOW-ART label or in the instructions for use (indications, method of use, contraindications, side effects, warnings, etc.), i.e. is it complete, sufficient and understandable?

The answer NO should be justified by explaining what information is missing or unclear.

What is understandable or missing?*

In the past 5 years, during your professional practice, has it ever happened that FLOW-ART:

Select one answer in each line

Have you ever observed any adverse reactions after using the FLOW-ART?

The answer YES must be explained.

What adverse reactions have been observed?*

Do you consider FLOW-ART to be safe for the clinical indications described in the instructions for use?

The answer NO should be explained.

Why not?*

Do you have any comments, suggestions, ideas or concerns regarding the FLOW-ART medical device that would help us improve our product?

Where do you usually obtain information about ARKONA products?

Select one or more answers
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Evaluation of the clinical effectiveness and safety of the FLOW-ART medical device

THANK YOU SO MUCH FOR GIVING US YOUR VALUABLE TIME!

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Dziękujemy za poświęcony czas i udzielone odpowiedzi.