Survey (Tech)

(Nail Tech, Salon Owner, Cosmetologist, Aesthetician)

Survey for Dermatological Pathology caused by:

Responses to the survey are optional/confidential.

| Home|

1. Are you a:

(Mark any or all)

Nail Tech

Salon Owner

Cosmetologist

Aesthetician

2. To receive updated information please complete: (Optional)

First Name:		Last Name:
Street Address:		City:
State:		Zip Code:
Phone Number:		Fax Number:
Email Address:

3. Do you currently practice as a nail tech, cosmetologist, aesthetician or are you retired or a non-practicing salon owner:

Yes No Retired Non-Practicing

4. Are you under a physician’s treatment or any medical treatment from any nail or beauty salon related medical problem,
salon inhalation work disorder (SIWD), allergy related skin problem or contact dermatitis from chemicals used in facials,
manicure or pedicures or pulmonary disorder related to the beauty salon market:

Yes No

If Yes, what medical problem do you have:

(Mark any or all)

5. Have any of your clients ever received an infection from your services:

Yes No

If Yes, what problems:

(Mark any or All)

Fungal Nails

The Greenies

Bacterial Infections

Allergic reaction to acrylics nails

Allergic reaction to chemicals

Sick from breathing vapors

6. Do you personally know of any other nail tech whose clients have had nail infections:

Yes No

7. Have you ever referred your clients to a doctor because of:

(Mark any or All)

An accident in a salon	A medical problem you have recognized	Fungal Nails	Skin lesions
Skin allergies	Other

8. What kind of doctors have you referred your clients to:

9. Do you keep a list of clients:

Yes No

                   If Yes what information is on record:

                              (Mark any or All)

Name & Address

History of Medical Problems

Contact Numbers

Name of their personal Physician

10. Do you clean your whirlpool chairs:

(Mark any or All)

At the end of each day

The end of each week

Between clients

Do you log this cleaning information anywhere:

Yes No

11. How do you clean the surfaces of your pedicure/whirlpool chairs:

(Mark any or All)

Low strength bleach	Medium strength bleach
Pure bleach	Quats
Alcohol	Phenols
Commercial cleaners	Other

12. How do you disinfect your pedicure/whirlpool chairs:

(Mark any or All)

Low strength bleach	Medium strength bleach
Pure bleach	Quats
Alcohol	Phenols
Commercial cleaners	Other

13. Do you clean the tubes and filters of your pedicure/whirlpool chairs:

Yes No

14. Would you like to see better rules and regulations coming from your state cosmetology board:

15. Would you like to see a medical specialist become a member of your state cosmetology board to review health
related nail salon problems or to ask questions regarding what medical issues in nail salons affect the general public:

Yes No

16. Do you believe your method of sanitation is adequate to protect the public:

Yes No

17. Have you ever used the same nail file on more than one person:

Yes No

18. Have you ever accidentally injured a client with a nail nipper, nail file, chemical peel , cuticle remover
or acrylic nail application service:

Yes No

If yes which one? (Mark any or All)

Nail Nipper	Nail File
Chemical Peel	Cuticle Remover
Acrylic nail application service

19. Do you believe the salon industry should sterilize their instruments:

Yes No

20. Do you believe the chemicals you work with are as safe as they should be:

Yes No

21. Are you worried about medical problems from breathing vapors of the products you use in the salon industry:

Yes No

22. Does your salon have a ventilation system to protect yourself and clients:

Yes No

23. Do you believe the nail salon industry could do more to protect the general public and yourself from chemical exposure:

Yes No

24. Do you believe the salon beauty industry should do more to protect the general public from bacterial, viral or fungal
infections in the salon:

Yes No

25. Do you sell products in your salon to treat the “Greenies”, fungal nails, or nail problems or skin problems:

Yes No

If Yes what products or the name of the products or the major companies who sell these products:

(Enter below)

26. Do you believe that nails techs would benefit by required continuing education credits to improve your
knowledge base or learn how to improve your services:

Yes No

27. Would you work in a nail salon if it was operated by a physician using only fresh packs of sterilized instruments
and you learned advanced procedures:

Example: A spa called Physicians Nail Spa

Yes No

28. Do you believe your state should hold an annual seminar to provide CEUs or provide an online computer program
to accomplish this service:

Yes No

29. What do you believe is the most important change you would like to see in this industry:

(Enter your comments below)

If you do not submit the survey online, Please email at: rts9999999@aol.com

(and I will fax you a survey to fill out) Phone: 423-756-3668

Fax: 423-886-1142

Dr. Robert Spalding

1225 Taft Hwy

Signal Mtn, TN 37377