JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
RDA Clinical Test
This test will help to determine your clinical skillset prior to starting work
Sign in to Google
to save your progress.
Learn more
* Indicates required question
What is your First & Last Name?
*
Your answer
Can you take X-Rays using a Nomad?
Yes
No
Clear selection
What Type of Procedures Have You Assisted With In The Past?
Fillings
Crowns
Extractions
New Patient Exams
Hygiene
Do you know how to chart existing restorations and know teeth numbers?
*
Yes, By Looking Inside the Mouth
Yes, By Looking at X-Rays
I do not know how
Required
Tell me what you see for Patient #1. Check any boxes you think are correct.
Wisdom Teeth
Right Side of the Mouth
Left Side of the Mouth
N/A
Missing Teeth
Root Canals
Fillings
Decay
Wisdom Teeth
Right Side of the Mouth
Left Side of the Mouth
N/A
Missing Teeth
Root Canals
Fillings
Decay
What tooth number is being indicated by the arrow?
#31
#8
#19
#18
Clear selection
What Filling Material Is Used On This Tooth?
Composite
Amalagam
Resin
Its Not A Filling!
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Pure Holistic Dental.
Report Abuse
Forms
