Questionnaires for a proper treatment

KvPA makes use of health surveys as a tool for proper treatment. Furthermore, having a health questionnaire completed beforehand is an obligation under the Dutch Medical Treatment Act (WGBO), article 452. The Healthcare inspectorate checks that the practitioner meets this obligation.

KvPA uses two questionnaires:

  1. the Health questionnaire;
  2. the Halitosis questionnaire.

Both questionnaires have been developed by KvPA.
The questionnaires are available in hard copy as well as on line, using an Internet application.

Internet application Halitosis questionnaire

With this internet application, patients can complete the halitosis questionnaire in a place and at a time of their choice.

The questionnaire is completely automated. 

Patients receive an email containing a URL of the questionnaire. After completing the questionnaire, the patient and the practitioner will receive a pdf with the provided answers. The pdf can be inserted in the patient's file.
The patient completes only those questions relevant to him/her.  An alert ensures that the practitioner is informed immediately, by email, of a 'critical diagnosis'. Special treatment necessary.
Basic statistics of the completed questionnaires can be used to improve patient care.

Structure of the questionnaire

The questionnaire consists of three parts.
The first part concerns the personal details. The second is a health questionnaire and the third part specifically concerns halitosis.
The following topics will be dealt with:

Part 1 (26 questions):

Part 2 (29 questions):

  • Heart and vascular diseases
  • Haemophilia
  • Use of medication
  • COPD
  • Allergy
  • Diabetes
  • Thyroid function
  • Kidney function
  • Blood Pressure
  • Use of medication
  • Communicable diseases
  • Gnashing

Part 3 (38 questions):

  • Bad breath in general
  • Contact with others
  • Major Life Events
  • Nutrition
  • Smoking
  • Medical History
  • Oral Care

Availability for third parties

The Internet application is also available to third parties.
A Secure Sockets Layer (SSL)* connection guarantees safe processing of the data.

For more information:

Robbert Lubberhuizen

* Secure Sockets Layer (SSL) are cryptographic protocols that provide communication security on the Internet