Belmont Industry Insights Survey

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Company

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About You

Help us get to know your role and background so we can better understand your perspective.

Name*

Prefix First Last Suffix

Business Name*

Dental Industry Role

Other Industry Role:

Address*

City State

Phone

Email*

Section 1: Background

Which best describes your role in the dental industry?*

Dentist / Practice Owner

Dental Assistant or Hygienist

Dealer Equipment Specialist / Sales Rep

Service Technician / Installer

Architect / Designer / Contractor

Banker / Lender / Financial Advisor

Manufacturer Partner or Supplier

Other (please specify)

Choose all that apply.

General Dentistry

Pediatric Dentistry

Orthodontics

Periodontics

Oral & Maxillofacial Surgery

Prosthodontics

Endodontics

Dental Hygienist

Dental Assistant

Choose all that apply.

General Dentistry

Pediatric Dentistry

Orthodontics

Periodontics

Oral & Maxillofacial Surgery

Prosthodontics

Endodontics

Dental Hygienist

Dental Assistant

Other (specify)

How familiar are you with Belmont as an equipment brand?*

Very familiar - I actively work with or recommend Belmont equipment

Somewhat familiar - I know the brand and its reputation

Heard of it - I recognize the name but don’t know the details

Not familiar - This is my first time learning about Belmont

Before today, were you aware that Belmont equipment is manufactured in Japan?

How important is Japanese manufacturing to your perception of quality and reliability? (1 = Not important → 5 = Extremely important)

1	2	3	4	5

Section 2: Brand Perception

Which words or qualities best describe Belmont in your mind? (Select up to 3)*

Craftsmanship

Durability

Reliability

Comfort

Precision

Quality

Innovation

Ergonomics

Design / Aesthetics

Value

Trustworthiness

If you could describe Belmont in one sentence, what would it be?*

When you think of Belmont’s legacy and craftsmanship, what comes to mind?

What qualities define “craftsmanship” to you in a dental equipment context?

How would you describe Belmont’s design and aesthetic appeal?

Exceptional - distinctive and timeless

High-quality - modern yet functional

Good - clean and professional

Average - practical but unremarkable

Needs improvement

Section 3: Performance & Experience

How would you rate Belmont’s craftsmanship and durability compared with other brands? (1 = Much worse → 5 = Much better)*

1	2	3	4	5

How would you rate Belmont’s ergonomics and support for clinicians and patients? (1 = Much worse → 5 = Much better)*

1	2	3	4	5

How confident are you that Belmont equipment provides long-term dependable performance? (1 = Not confident → 5 = Extremely confident)*

1	2	3	4	5

How does Belmont compare in innovation and technology adoption? (1 = Behind most brands → 5 = Leading the industry)*

1	2	3	4	5

How many additional years beyond the standard warranty do you expect Belmont equipment to last?*

0-4 years

5-10 years

11-15 years

16-20 years

20+ years

N/A

How likely are you to recommend Belmont to a colleague or client? 0 (Not likely at all) → 10 (Extremely likely)*

1	2	3	4	5	6	7	8	9	10

Section 4: Impact & Differentiation

What experiences or interactions with Belmont or its products have shaped the way you think about the company’s impact on dentists and their practices?*

What most clearly sets Belmont apart from other equipment manufacturers?*

How does Belmont contribute to clinical workflow efficiency or patient comfort?

How does Belmont support practice growth and modernization?

What is one thing Belmont could communicate more clearly to your professional community?

What stories or examples have stood out to you about Belmont in recent years?

Section 5: Industry Perspective

What trends do you see shaping the dental equipment industry over the next five years?

When you imagine the future of dental care, how do you see Belmont contributing to or shaping that vision?

What professional qualities make a manufacturer trustworthy to you?

What product category do you most associate with Belmont?

Dental Chairs

Delivery Systems

Lights

Cabinetry

Imaging Systems

Other (specify)

What information sources most influence your equipment recommendations or purchases? (Select up to 3)

Dealer representatives

Colleagues or peer recommendations

Dental trade shows / events

Manufacturer websites

Industry publications / journals

Online reviews / forums

Social media or YouTube content

Other (specify)

How important are sustainability or ethical manufacturing practices in your purchase decisions? (1 = Not important → 5 = Extremely important)

1	2	3	4	5

Do you believe equipment influences patient perception of care?

Yes - it strongly influences patient trust and comfort

Somewhat - patients notice design and cleanliness

Minimal impact - patients rarely focus on equipment

Not at all

How would you describe the atmosphere that help doctors and clinical staff perform their best in the operatory? (Select up to 3)*

Comfortable

Confident

Focused

Efficient

Supportive

Calm

Professional

Trusted

Balanced

Precise

Other (specify)

What do you want your patients to feel when they enter or sit in your operatory? (Select up to 3)*

Relaxed

Comfortable

Safe

Confident

Reassured

Calm

Welcomed

At Ease

Cared For

Respected

Other (specify)

What improvements or innovations would you like to see from Belmont in the future?

What prevents dentists or practices from choosing Belmont today?

Section 6: Open Reflection

If you could share one thing about Belmont with the wider dental community, what would it be?*

Is there a memorable story, experience, or positive outcome that illustrates Belmont’s value or reliability?*

Section 7: Consent and Follow-Up

We won’t change what you say. Your responses will remain your own. This permission simply allows us to edit for clarity, length, or formatting if we use your statement in marketing, sales, or educational materials.

Agreement*

I Agree*

I have read the Terms & Conditions of this web site in its entirety and I agree to all of the terms; including the provision for Takara Belmont to use, change, and reproduce all of the content that I submit for promotional and advertising purposes.

Optional Participation

I'm open to being contacted for a short follow-up discussion, interview, or story feature.

I’d like to participate in future Belmont surveys or professional feedback sessions.

I’d like to receive updates on new Belmont products, events, or news.

Belmont General Feedback & Survey

About You

Section 1: Background

Section 2: Brand Perception

Section 3: Performance & Experience

Section 4: Impact & Differentiation

Section 5: Industry Perspective

Section 6: Open Reflection

Section 7: Consent and Follow-Up