Dentaltown July 2017 - 110

CONTINUING
EDUCATION
ANSWER
SHEET

Instructions: To receive credit, complete the answer sheet and mail it, along with a check or credit card
payment of $36, to: Dentaltown.com, 9633 S. 48th St., Suite 200, Phoenix, AZ 85044. You may also fax this
form to 480-598-3450 or answer the post-test questions online at dentaltown.com/ce. This written selfinstructional program is designated for 1.5 hours of CE credit by Farran Media. You will need a minimum
score of 70 percent to receive your credits. Participants pay only if they wish to receive CE credits; thus
no refunds are available. Please print clearly. This course is available to be taken for credit July 1, 2017,
through its expiration on July 1, 2020. Your certificate will be emailed to you within 3-4 weeks.

To Buffer or Not to Buffer

CE Post-Test
1.

A

B

C

D

2.

A

B

C

D

3.

A

B

C

D

4.

A

B

C

D

Name ______________________________________________________________________________________________________

5.

A

B

C

D

Address ___________________________________________________________________________________________________

6.

A

B

C

D

7.

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B

C

D

8.

A

B

C

D

9.

A

B

C

D

10.

A

B

C

D

by Charles D. Schlesinger, DDS, FICOI
License Number ______

______

______

______

______

______

______

______

______

______

AGD# _____________________________________________________________________________________________________

City ____________________________________________________

State ___________

ZIP ________________________

Daytime phone _____________________________________________________________________________________________
Email (required for certificate) ______________________________________________________________________________
o Check (payable to Dentaltown)

Please circle your answers.

o Credit card (please complete the information below and sign; we accept Visa, MasterCard and American Express.)
Card number ________________________________________________________________________________________________
Expiration date-month/year ____________ /________________________
Signature ______________________________________________________________________ Date __________________________________________________

Program Evaluation (required)
Please evaluate this program by circling the corresponding numbers: (5 = Strongly Agree to 1 = Strongly Disagree)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.

Course administration was efficient and friendly
Course objectives were consistent with the course as advertised
COURSE OBJECTIVE #1 was adequately addressed and achieved
COURSE OBJECTIVE #2 was adequately addressed and achieved
COURSE OBJECTIVE #3 was adequately addressed and achieved
COURSE OBJECTIVE #4 was adequately addressed and achieved
Course material was up to date, well-organized, and presented in sufficient depth
Instructor demonstrated a comprehensive knowledge of the subject
Instructor appeared to be interested and enthusiastic about the subject
Audio-visual materials used were relevant and of high quality
Handout materials enhanced course content
Overall, I would rate this course (5 = Excellent to 1 = Poor):
Overall, I would rate this instructor (5 = Excellent to 1 = Poor):
Overall, this course met my expectations

Comments (positive or negative):

5
5
5
5
5
5
5
5
5
5
5
5
5
5

4
4
4
4
4
4
4
4
4
4
4
4
4
4

3
3
3
3
3
3
3
3
3
3
3
3
3
3

2
2
2
2
2
2
2
2
2
2
2
2
2
2

1
1
1
1
1
1
1
1
1
1
1
1
1
1

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____________________________________________________________________________________________________________________________________________________
For questions, contact Director of Continuing Education Howard Goldstein at hogo@dentaltown.com.

110

JULY 2017 // dentaltown.com
http://www.Dentaltown.com http://www.dentaltown.com/ce http://www.dentaltown.com
Table of Contents for the Digital Edition of Dentaltown July 2017
