Proforma for Completion by Patients

Invitation to complete questionnaires:
We understand that you are likely to be suffering from a nerve injury due to a dental procedure, trauma or surgery.
  • We invite you to complete the following survey as part of your clinical assessment .
Why should I complete these questionnaires?
  • Completing the questionnaires will enable us to identify what treatment you need
  • Through research, this will help us improve the outcome of your nerve injury and your overall quality of life
  • All data collected is anonymized and stored in a secure environment
  • We need your consent to use your information for research purposes in order to help prevent nerve injuries in the future.
  • Although some of the questions may seem repetitive, please do answer all of the questions as your answers will provide us with essential information about your condition
  • There is a 'save and continue later' option within the survey that will allow you to answer the questions at different times - you do not need to complete the questionnaires all at once.
  • You can also review your answers at any time.
The next couple of pages is the 'Patient Information Sheet' for this study (REC Ref 14/LO0500, Dated 08/05/2014). It contains information about what will happen to the data collected and data protection policy.

The Head of the group for this project is Professor Tara Renton, who may be contacted at if you have any further questions.
We thank you for your time to complete all items.