Survey FormFort Bend Dental Academy Post Course/Needs AssessmentDate of Course(Required) DD slash MM slash YYYY Type of Course(Required) Participation/Hands On Product Training Lecture Other:Location of Course(Required)What is your name? (You do not have to provide.)(Required)What is your educational level?(Required) Introductory Intermediate Advanced ExpertWhat is your profession?(Required) Dentist Hygienist Specialist Dental Assistant Other:How many years have you been in practice or worked in the dental industry?What type of practice do you work in? Private Group Institutional/Hospital Other:Preferred Course Length?(Required) Half Day (3-4 Hours) Full Day (7-8 Hours) Weekend (Sat-Sun) Other:Preferred Time?(Required) Morning Afternoon EveningPreferred Day?(Required)Preferred Teaching Method?(Required) Lecture Hands-On Online BothIf multi-day courses are offered, would you attend planned networking events like receptions or dinners?(Required) Yes NoWhat is the price range you would consider paying for this course?*Would you be interested in team training?(Required) Yes No MaybeWhat future topics are you interested in?(Required)What do you rate this course? (1 being the lowest and 5 being the highest)(Required)Would you recommend to a colleague?(Required) Yes No MaybePlease give us any feedback you think we need to make your next course better.(Required)
