DDDS Program Evaluation and CE Request Form for Dr. Andrea Tory Cracked Tooth Seminar January 18, 2022 Zoom participants

Thank you for participating in the Detroit District Dental Society presentation by Dr. Andrea  Tory. 

To receive a Continuing Education Certificate for this presentation, you must complete this survey with contact information to receive the emailed electronic certificate.

The CE certificate is optional, the survey may be submitted without contact information and if you wish to provide an anonymous evaluation of the presentation.

--Detroit District Dental Society, centraloffice@detroitdentalsociety.com, 313.338.4900; Marcy Dwyer, MBA, CAE, CMP, Executive Director

Program Content

The program goals were to give more information on working with cracked teeth and possible treatments. Did the content cover the objectives?


Speaker Presentation

Did the style and delivery of the speaker improve the presentation?


The program provided me with increased knowledge and information.



Content Level

Was the content appropriate for the zoom program? Please select all the following that apply.





Open question for any additional feedback on the presentation.

Continuing Education (CE) Certificate

If you complete the required personal information to receive the CE certificate,  the data will only be used for the dental association communication. Your personal contact information will never be released or sold to any third party outside the dental association. 
Do you wish to receive a Continuing Education Certificate for this program, Two (2) CE?

Dental job function - please select one for CE certificate





Name as it should appear on the certificate.
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