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D4: Dr Purav Mehta Dental survey

Dr Purav Mehta believes in empowering the patient with a platform to share their preferences and experience. Answering this simple survey about your dental habits will help us understand your requirements and provide you with the best dental treatment experience. 
1. Do you want to share your identity with the Dr Purav? 
If you deny your demographic information will be kept anonymous. 
This question requires a valid number format.
This question requires a valid email address.
5. Gender *This question is required.
This question requires a valid number format.

What kind of toothbrush do you use?

*This question is required.
8. How often do you change your toothbrush? *This question is required.
9. How many times do you brush your teeth in a day? *This question is required.
10. Do you use dental floss? *This question is required.
How often do you floss? *This question is required.
11. Do you use a tongue cleaner/scraper? *This question is required.
12. What kind of toothpaste do you use? *This question is required.
13. How long is it since you last saw a dentist? *This question is required.

What was the reason of your last visit to the dentist?

*This question is required.
15. Do you use any of the following types of tobacco? *This question is required.
16. We conduct such simple paid surveys to support medical research, would you like to participate in such other surveys and get an opportunity to earn rewards? ( If you say yes we will contact you only with survey offers, we will never get in touch with any other unsolicited communication) *This question is required.