NM1. To which national dental organizations do you currently belong? (Check all that
apply.)
I do not belong to any nation...
National Dental Association state or local dental organizations
Hispanic Dental Association state or local dental organiza...
Professional financing
Defibrillator services
Emergency response systems
Discounted liability insurance
Scheduling/front o...
NM9. On average, how much continuing dental education (CE) credit hours do you earn
in a year?
0-10
11-20
21-30
31-40
More...
NM14. Please rank the following based on how important each is to you when deciding
on whether or not to attend a CE cours...
Neutral
Disagree
Strongly Disagree

NM20. Please indicate the number of years you've been in practice:
Less than 5 years
5...
NM25. Please indicate whether you agree or disagree with the following statements:
Agree
Neutral
Disagree

-There is ample...
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  1. 1. NM1. To which national dental organizations do you currently belong? (Check all that apply.) I do not belong to any national dental organizations. American Dental Association Canadian Dental Association American Association of Public Health Dentistry American Association of Endodontists American Academy of Oral & Maxillofacial Pathology American Academy of Oral & Maxillofacial Radiology American Association of Oral and Maxillofacial Surgeons American Association of Orthodontists American Academy of Pediatric Dentistry American Academy of Periodontology American College of Prosthedontists American College of Dentistry American Academy of Cosmetic Dentistry Academy of General Dentistry Academy of Laser Dentistry National Dental Association Hispanic Dental Association American Academy of Implant Dentistry International Association for Orthodontics American Dental Education Association International College of Dentists Academy of Dentistry International Other (Please specify.) NM2. To which state or local dental organizations do you currently belong? (Check all that apply.) I do not belong to any state or local dental organizations. American Dental Association state or local dental organizations Canadian Dental Association state or local dental organizations American Association of Public Health Dentistry state or local dental organizations American Association of Endodontists state or local dental organizations American Academy of Oral & Maxillofacial Pathology state or local dental organizations American Academy of Oral & Maxillofacial Radiology state or local dental organizations American Association of Oral and Maxillofacial Surgeons state or local dental organizations American Association of Orthodontists state or local dental organizations American Academy of Pediatric Dentistry state or local dental organizations American Academy of Periodontology state or local dental organizations American College of Prosthedontists state or local dental organizations American College of Dentistry state or local dental organizations American Academy of Cosmetic Dentistry state or local dental organizations Academy of General Dentistry state or local dental organizations Academy of Laser Dentistry state or local dental organizations
  2. 2. National Dental Association state or local dental organizations Hispanic Dental Association state or local dental organizations American Academy of Implant Dentistry state or local dental organizations International Association for Orthodontics state or local dental organizations American Dental Education Association state or local dental organizations International College of Dentists state or local dental organizations Academy of Dentistry International state or local dental organizations Other (Please specify.) NM3. What is the primary reason you would join a dental organization? (Choose only one answer.) I would never join a dental organization – Please proceed to question 5. Educational opportunities Professional networking Social networking Discounts on professional products and services Discounts on personal products and services Career opportunities To be a mentor To find a mentor Patients have a positive perception of me due to my membership Colleagues have a positive perception of me due to my membership For the greater good of the profession. Other (Please specify.) NM4. Please rank the following based on reasons why you would join a dental organization (1 = most important reason; 10 = the least important reason): Educational opportunities Professional networking Social networking Discounts on professional products and services Discounts on personal products and services Career opportunities To be a mentor To find a mentor Patients have a positive perception of me due to my membership Colleagues have a positive perception of me due to my membership For the greater good of the profession. Other (Please specify.) NM5. What types of professional products or services are of most interest to you as a dentist? (Select all that apply.) Credit card processing Payroll processing Patient financing
  3. 3. Professional financing Defibrillator services Emergency response systems Discounted liability insurance Scheduling/front office software Marketing support Staff training tools Amalgam recycling program Office supply store discount Other (Please specify.) NM6. What types of personal products or services are of most interest to you? (Select all that apply.) Hotel discounts Car rental discounts Auto insurance Home insurance Life insurance Gym membership discount Other (Please specify.) NM7. Compared to five years ago, would you say your practice’s net income has: Increased by less than X percent Increased by X-X percent Increased more than X percent No change Decreased by less than X percent Decreased by X-X percent Decreased more than X percent Not sure NM8. Please indicate how much you agree or disagree with the following statement: I couldn’t be happier with my career. Strongly Agree Agree Neutral Disagree Strongly Disagree Now we would like to ask you about continuing education.
  4. 4. NM9. On average, how much continuing dental education (CE) credit hours do you earn in a year? 0-10 11-20 21-30 31-40 More than 40 NM10. Which type of CE course do you take most often? (Please choose only one answer.) Lecture Participation/Hands-on Self-study Internet NM11. Assuming cost is not a factor, rank the following types of CE courses based on your interest level (1 = highest interest level; 4 = lowest interest level): Lecture Participation/Hands-on Self-Study Internet NM12. Please rank the following CE course subjects based on your interest level (1 = most interested; 15 = least interested): Basic Science Endodontics Esthetics Implants Myofascial Pain Dysfunction/Occlusion Operative Dentistry Oral and Maxillofacial Surgery Oral Medicine, Oral Diagnosis Orthodontics Pediatric Dentistry Practice Management Prosthodontics – Fixed Prosthodontics – Removable Special Patient Care Other (Please specify.) NM13. What type of speaker are you most interested in hearing from at educational events? (Please choose only one answer.) Only big name speakers Only up-and-coming speakers A mix of both big-name and up-and-coming speakers No preference
  5. 5. NM14. Please rank the following based on how important each is to you when deciding on whether or not to attend a CE course (1 = most important; 4 = least important): Cost Speaker Topic Location Other (Please specify.) NM15. How far away from your practice would you travel for CE? Less than 10 miles 11-20 miles 21-30 miles 31-40 miles 41-50 miles More than 50 miles NM16. What time is most convenient for you to take CE courses? Weekday, anytime Weekday, morning Weekday, afternoon Weekend, anytime Weekend morning Weekend afternoon No preference NM17. In terms of size, what type of CE course are you most interested in attending? Small (Less than X attendees) Medium (X-X attendees) Large (More than X attendees) No preference NM18. From what source do you most often receive your CE? (Please choose only one answer.) AGD ADA State or local associations or groups (non-profit) For-profit providers such as Dentaltown Other dental practices in my area Other (Please specify.) NM19. Please indicate how much you agree or disagree with the following statement: The CE courses I attend provide me with information I can apply in my practice. Strongly Agree Agree
  6. 6. Neutral Disagree Strongly Disagree NM20. Please indicate the number of years you've been in practice: Less than 5 years 5-10 years 11-20 years 21-30 years More than 30 years Not in practice NM21. What type of practice do you have? Associate in a practice Solo Group Hospital-Based Teaching (Specify institution) Resident Federal Services (Specify branch) NM22. In which <insert state> county is your practice? [drop down list] <insert counties> Now we would like to ask you about the communication for CE. NM23. What is your preferred method of learning about CE: Mail Publication E-mail Web site Phone Other <text box> N/A NM24. Please indicate the approximate number of communications you receive in an average month about CE events: NA 0-5 6-10 11-15 16-20 21-25 More than 25
  7. 7. NM25. Please indicate whether you agree or disagree with the following statements: Agree Neutral Disagree -There is ample CE offered locally. -I am well-informed about all of the available CE in my area

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