NEEDS ASSESSMENT SURVEY

NEEDS ASSESSMENT SURVEY

We appreciate your involvement with our continuing education courses and would like to hear your opinion. Please complete this survey so that we may improve upon our program to meet your continuing education needs.

1. I am a (check one):

AGD Dentist
Non-AGD Dentist
Hygienist
DANB Dental Asst
Non-DANB Dental Assistant
Office Staff
Other

2. How often do you attend continuing education courses?

Less than 15 hours per year.
Between 16 and 30 hours per year
Between 31 and 45 hours per year.
Between 46 and 60 hours per year.
More than 60 hours per year.
Not applicable.

3. What is most important in your selection of continuing education providers?

Cost
Location
Subject Area
Instructional Methods (self-instruction, lecture, participations, online, etc.)
Instructor Qualification
Other, please explain:

4. Preferred Method(s) of instruction:

Self-Instructional Online

Self-Instructional Mail

Self-Instructional Video or CD

In-office participation

Participation: Live Patients

Lecture

Weekend Workshop or Meeting	Seminar

5. What specific subjects are of interest to you?

6. What are your suggestions for future courses?

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