.

Evaluation of the clinical effectiveness and safety of the SEALPRIM medical device

Dear Sir/Madam,


Please take a few minutes


to complete the following survey.

Secured
Survio
Create a survey
Evaluation of the clinical effectiveness and safety of the SEALPRIM 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 Database, which is also the administrator of your personal data. Details regarding ARKONA's personal data protection policy are available at: https://arkonadent.com/wp-content/uploads/2025/05/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 advised that your personal data will not be collected, processed or disseminated without your knowledge and consent. It will be used solely to confirm that the survey has been completed by an authorised person.

Address of the dental clinic/ practice

Medical Representative Initials

If applicable
Stwórz ankiety online za darmo ✓ Survio pomoże Ci
Evaluation of the clinical effectiveness and safety of the SEALPRIM medical device

Since when have you been using the SEALPRIM medical device?

Select one answer

How often do you use SEALPRIM in your practice?

Select one answer

How would you assess the volume (1 g) of material in the SEALPRIM package?

Select one answer

For which clinical indications do you use the SEALPRIM medical device?

You can select any number of options

What other indications do you use SEALPRIM for?*

Have you ever used the medical device SEALPRIM on:

Select one answer in each line

How would you assess the clinical effectiveness of the SEALPRIM device in terms of the clinical indications listed in the Instructions for Use of the medical device?

1 – very low, 5– very high

Please indicate other indications*

Please provide your indications and rating from 1 to 5

How long do you estimate the durability of SEALPRIM to be – how long does the sealant remain in the patient's mouth?

Select one answer

How would you assess the retention time of SEALPRIM in the patient's mouth compared to other materials of a similar type?

Select one answer

In your opinion, what are the main factors that most influence the durability of SEALPRIM in the patient's mouth?

You can select up to 3 answers

How would you assess the following functional characteristics and features of SEALPRIM?

(1 – very low, 5 – very high)

How would you assess the information on the SEALPRIM 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.

During the last 3 years of your professional practice, has the SEALPRIM medical device ever:

Select one answer in each line

What kind of allergic reaction did SEALPRIM cause?*

Have you ever observed any adverse reactions after using SEALPRIM?

The answer YES must be explained. What adverse reactions have been observed?

What adverse incident did you observe?*

Do you consider SEALPRIM to be safe for the clinical indications described in the instructions for use?

The answer NO should be explained.

Why not?*

What factors do you usually consider or would consider when deciding to purchase this type of material?

Select one answer

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

Where do you usually obtain information about ARKONA products?

Select one or more answers
Stwórz ankiety online za darmo ✓ Survio pomoże Ci
Dziękujemy za poświęcony czas i udzielone odpowiedzi.