To participate in the 2000 survey, simply fill in the blank or circle the appropriate response for each question. Please return the survey by June 23, 2000. And thanks for participating. The results will be published in the October 2000 issue.
1.) In what state do you practice? ________________
2.) Gender: [1] Female [2] Male
3.) How many years have you been a licensed hygienist?
[1] 1-5 years [2] 6-10 years [3] 11-15 years
[4] 16-20 years [5] 21-25 years [6] more than 25 years
4.) How would you describe your primary employer?
[1] General dentist
[2] Government/public health
[3] Specialist
[4] I am a self-employed hygienist
[5] College or other dental education facility
[6] Dental manufacturer
[7] Nondental occupation
5.) In how many dental practices do you work?
[1] One [2] Two
[3] Three [4] Four or more
6.) Approximately how many hours a week do you personally practice?
[1] Under 12 hours [2] 12-20 hours
[3] 21-30 hours [4] 31-35 hours
[5] 36-40 hours [6] More than 40 hours
7.) What do you estimate your total income as a dental hygienist will be in 2000?
$________________
8.) Does your answer to question #7 include anticipated commissions?
[1] No, I do not earn commissions
[2] I earn under 29% in commissions
[3] I earn between 29 and 50% in commissions
[4] I earn more than 50% in commissions
[5] My entire income is on a commission basis
9.) If you are paid by an hourly or daily rate, please indicate the rate below:
[1] Hourly rate $_________
[2] Daily rate $_________
10.) What benefits do you receive? (check all that apply)
[1] Paid vacation
[2] Paid holidays
[3] Employer-provided health insurance
[4] Pension plan or 401(k) program
[5] Profit-sharing program other than commissions
11.) Rate your satisfaction level with the income you currently earn.
[1] Very satisfied [2] Content [3] Very unsatisfied
12.) Rate your satisfaction level with the employer-provided benefits you currently earn.
[1] Very satisfied [2] Content [3] Very unsatisfied
13.) Rate your satisfaction level with the workplace environment and management policies established by your employer.
[1] Very satisfied [2] Content [3] Very unsatisfied
14.) Rate your satisfaction level with your decision to pursue a career in dental hygiene.
[1] Very satisfied [2] Content [3] Very unsatisfied
Return this survey to RDH by:
* Mail: RDH, attn: Laura DeShazer, P.O. Box 3306, Tulsa, OK 74101
* Fax: (918) 831-9804. Please do not fax and then mail your answers.
* E-mail: [email protected]. Make sure your answers are numbered and clearly correspond with the related questions.
Thank you for taking the time to respond.
