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Membership Survey
We want to hear from you!
Name (Optional)
Click to add
(Optional)
(?)
Age
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Please enter your age.
(?)
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
From this list, which of these are or would be the most valuable to you? Choose a minimum of four.
Insurance and retirement resources
Advocacy Initiatives
Affiliated programs and products
Continuing Education
Health and Wellness Committee
New Dentist Committee
Four Year Mentor Program - (Member - Student)
Referrals
Peer Review Mediation
Are there services or benefits that could be provided that would make membership more valuable to you?
Click to add
(?)
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
Please list any additional comments or questions you would like to share with us.
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About
Board Members
Committees Councils
NDA Calendar
Membership
Why Join
Benefits of Membership
Student Membership
Payment Options
Pay My Dues
Affiliated Products
Update My Information
Help Logging In
Membership Survey
ADA Member Credentialing
Advocacy
About
Member Access
Publications
FAQs On Rx Writing
Regulations
NDAPAC
Take Action
Events
NDA Events/Meetings
Northern Nevada Events
Southern Nevada Events
Northeast Nevada Events
Available CE Courses
Patient Resources
Find a Dentist
Dental Health FAQ
Low Income Resources
Why Should I See a Dentist?
What Do Dentists Do
Peer Review
Charities
NDA Foundation
NDA PAC
Give Kids A Smile
Benefit for Smiles
Angel Program
Hurricane Harvey Relief Effort
Careers
Dental Careers
Nevada Colleges & Universities
Associations
Classifieds
Submit New Ad Form
Pricing
"State":"NV"