Lets-Talk-Teeth-Intake-Questionnaire

Your feedback is important to us!

Please take 3 minutes to let us know about your experience with this course and how we can improve it. When complete, click Submit to view a link to download your certificate.

Content was well organized and easy to understand.
Strongly disagree Disagree Neutral Agree Strongly agree
I will be able to apply the principles covered in this course to my practice.
Strongly disagree Disagree Neutral Agree Strongly agree
Content was presented in appropriate depth.
Strongly disagree Disagree Neutral Agree Strongly agree
Learning assessment activities (clinical cases, post-test) were appropriate.
Strongly disagree Disagree Neutral Agree Strongly agree
Material was presented in a fair, non-commercial and unbiased manner.
Strongly disagree Disagree Neutral Agree Strongly agree
Activity achieved the stated learning objectives*.
Strongly disagree Disagree Neutral Agree Strongly agree
What suggestions do you have to improve this module?
What changes will you make to your clinical practice as a result of completing this module?
Name
This field is for validation purposes and should be left unchanged.

Your feedback is important to us!

Please take 3 minutes to let us know about your experience with this course and how we can improve it. When complete, click Submit to view a link to download your certificate.

Content was well organized and easy to understand.
Strongly disagree Disagree Neutral Agree Strongly agree
I will be able to apply the principles covered in this course to my practice.
Strongly disagree Disagree Neutral Agree Strongly agree
Content was presented in appropriate depth.
Strongly disagree Disagree Neutral Agree Strongly agree
Learning assessment activities (clinical cases, post-test) were appropriate.
Strongly disagree Disagree Neutral Agree Strongly agree
Material was presented in a fair, non-commercial and unbiased manner.
Strongly disagree Disagree Neutral Agree Strongly agree
Activity achieved the stated learning objectives*.
Strongly disagree Disagree Neutral Agree Strongly agree
What suggestions do you have to improve this module?
What changes will you make to your clinical practice as a result of completing this module?
Phone
This field is for validation purposes and should be left unchanged.

Your feedback is important to us!

Please take 3 minutes to let us know about your experience with this course and how we can improve it. When complete, click Submit to view a link to download your certificate.

Content was well organized and easy to understand.
Strongly disagree Disagree Neutral Agree Strongly agree
I will be able to apply the principles covered in this course to my practice.
Strongly disagree Disagree Neutral Agree Strongly agree
Content was presented in appropriate depth.
Strongly disagree Disagree Neutral Agree Strongly agree
Learning assessment activities (clinical cases, post-test) were appropriate.
Strongly disagree Disagree Neutral Agree Strongly agree
Material was presented in a fair, non-commercial and unbiased manner.
Strongly disagree Disagree Neutral Agree Strongly agree
Activity achieved the stated learning objectives*.
Strongly disagree Disagree Neutral Agree Strongly agree
What suggestions do you have to improve this module?
What changes will you make to your clinical practice as a result of completing this module?
Comments
This field is for validation purposes and should be left unchanged.

Your feedback is important to us!

Please take 3 minutes to let us know about your experience with this course and how we can improve it. When complete, click Submit to view a link to download your certificate.

Content was well organized and easy to understand.
Strongly disagree Disagree Neutral Agree Strongly agree
I will be able to apply the principles covered in this course to my practice.
Strongly disagree Disagree Neutral Agree Strongly agree
Content was presented in appropriate depth.
Strongly disagree Disagree Neutral Agree Strongly agree
Learning assessment activities (clinical cases, post-test) were appropriate.
Strongly disagree Disagree Neutral Agree Strongly agree
Material was presented in a fair, non-commercial and unbiased manner.
Strongly disagree Disagree Neutral Agree Strongly agree
Activity achieved the stated learning objectives*.
Strongly disagree Disagree Neutral Agree Strongly agree
What suggestions do you have to improve this module?
What changes will you make to your clinical practice as a result of completing this module?
Email
This field is for validation purposes and should be left unchanged.

Your feedback is important to us!

Please take 3 minutes to let us know about your experience with this course and how we can improve it. When complete, click Submit to view a link to download your certificate.

Content was well organized and easy to understand.
Strongly disagree Disagree Neutral Agree Strongly agree
I will be able to apply the principles covered in this course to my practice.
Strongly disagree Disagree Neutral Agree Strongly agree
Content was presented in appropriate depth.
Strongly disagree Disagree Neutral Agree Strongly agree
Learning assessment activities (clinical cases, post-test) were appropriate.
Strongly disagree Disagree Neutral Agree Strongly agree
Material was presented in a fair, non-commercial and unbiased manner.
Strongly disagree Disagree Neutral Agree Strongly agree
Activity achieved the stated learning objectives*.
Strongly disagree Disagree Neutral Agree Strongly agree
What suggestions do you have to improve this module?
What changes will you make to your clinical practice as a result of completing this module?
Comments
This field is for validation purposes and should be left unchanged.

Your feedback is important to us!

Please take 3 minutes to let us know about your experience with this course and how we can improve it. When complete, click Submit to view a link to download your certificate.

Content was well organized and easy to understand.
Strongly disagree Disagree Neutral Agree Strongly agree
I will be able to apply the principles covered in this course to my practice.
Strongly disagree Disagree Neutral Agree Strongly agree
Content was presented in appropriate depth.
Strongly disagree Disagree Neutral Agree Strongly agree
Learning assessment activities (clinical cases, post-test) were appropriate.
Strongly disagree Disagree Neutral Agree Strongly agree
Material was presented in a fair, non-commercial and unbiased manner.
Strongly disagree Disagree Neutral Agree Strongly agree
Activity achieved the stated learning objectives*.
Strongly disagree Disagree Neutral Agree Strongly agree
What suggestions do you have to improve this module?
What changes will you make to your clinical practice as a result of completing this module?
Name
This field is for validation purposes and should be left unchanged.

Your feedback is important to us!

Please take 3 minutes to let us know about your experience with this course and how we can improve it. When complete, click Submit to view a link to download your certificate.

Content was well organized and easy to understand.
Strongly disagree Disagree Neutral Agree Strongly agree
I will be able to apply the principles covered in this course to my practice.
Strongly disagree Disagree Neutral Agree Strongly agree
Content was presented in appropriate depth.
Strongly disagree Disagree Neutral Agree Strongly agree
Learning assessment activities (clinical cases, post-test) were appropriate.
Strongly disagree Disagree Neutral Agree Strongly agree
Material was presented in a fair, non-commercial and unbiased manner.
Strongly disagree Disagree Neutral Agree Strongly agree
Activity achieved the stated learning objectives*.
Strongly disagree Disagree Neutral Agree Strongly agree
What suggestions do you have to improve this module?
What changes will you make to your clinical practice as a result of completing this module?
Name
This field is for validation purposes and should be left unchanged.

Your feedback is important to us!

Please take 3 minutes to let us know about your experience with this course and how we can improve it. When complete, click Submit to view a link to download your certificate.

Content was well organized and easy to understand.
Strongly disagree Disagree Neutral Agree Strongly agree
I will be able to apply the principles covered in this course to my practice.
Strongly disagree Disagree Neutral Agree Strongly agree
Content was presented in appropriate depth.
Strongly disagree Disagree Neutral Agree Strongly agree
Learning assessment activities (clinical cases, post-test) were appropriate.
Strongly disagree Disagree Neutral Agree Strongly agree
Material was presented in a fair, non-commercial and unbiased manner.
Strongly disagree Disagree Neutral Agree Strongly agree
Activity achieved the stated learning objectives*.
Strongly disagree Disagree Neutral Agree Strongly agree
What suggestions do you have to improve this module?
What changes will you make to your clinical practice as a result of completing this module?
Name
This field is for validation purposes and should be left unchanged.

Course Survey

Module Registration

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Please enter the full name of your organization (e.g. University of Alabama, not UA).
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*Those seeking AAP credit for this course MUST enter an AAP ID number. If you have previously registered you will be given the opportunity to enter your AAP ID number after login.

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