Membership Survey

Gender

Female
Male
Choose not to say

Years as a practicing dentist.

0-5
5-10
15-20
20+

Please select from the following, you are a:

General Dentist
Endodontist
Orthodontist
Pedoontist
Periodontist
Prosthodontist
Oral Maxillofacial Surgeon
Other Specialty not specified

How would you rate your overall satisfaction with your tripartite membership?

Extremely satisfied
Very satisfied
Moderately satisfied
Slightly satisfied
Not at all satisfied

How likely are you to recommend your tripartite membership?

Extremely likely
Very likely
Somewhat likely
Not very likely
Not at all likely

What is the likelihood you will continue your membership into the future?

Extremely likely
Very likely
Somewhat likely
Not very likely
Not at all likely

Thinking about the benefits (products and services) offered by your tripartite membership, how would you evaluate the benefits that are offered?

Excellent
Very Good
Fair
Poor
Have not experienced, but am aware
Was not aware

If you are currently in private practice, what is your employment situation?

Sole proprietor (the owner)
A partner (one of two or more owners)
Employee, associate or independent contractor in dentist-owned practice)
Employee, associate or independent contractor in dentist-owned practice)
Other

Please select the option that best describes your primary occupation.

Full-time private practice (32 or more hours per week)
Part-time private practice (less than 32 hours per week)
Dental school faculty/staff member
Federal Dental Services (Armed Forces, Veteran's Affairs, US Public Health Service, or other federal service)
State or local government employee
Community health center employee
Dental director/dental consultant/administrator in dental benefits industry
Not in practice/looking for openings/waiting for board
Retired
Other

Membership Survey

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