Dental Patients Survey
Thank you for taking time to complete this brief survey. We appreciate your insight as a dental patient on the bruxism technology we are developing and hope to maintain continual contact as we develop a device that meets your needs. Please provide your contact information below so we can keep you up-to-date on developments.

Note that in this survey the term "bruxism" is defined as teeth grinding or clenching.

Full Name *
Your answer
Email *
Your answer
Phone Number
Your answer
Your answer
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