Quality Resource Guide –
Xerostomia Revisited 4th Edition
Providing dentists with the opportunity for continuing dental education is an essential part of MetLife’s commitment to helping dentists improve the oral health
of their patients through education.
You can help in this
effort by providing feedback regarding the continuing education offering you have just completed.
MetLife Dental Quality Initiatives Program
501 US Highway 22
Bridgewater, NJ 08807
To Complete Program Traditionally, Please Mail Your Post Test and Evaluation Forms To:
FOR
OFFICE
USE ONLY
REGISTRATION/CERTIFICATION INFORMATION
(Necessary for proper certification)
Name (Last, First, Middle Initial): _____________________________________________________________
Street Address: ________________________________________________
Suite/Apt. Number ________
City: ___________________________________ State:______________ Zip: ___________________
Telephone: ___________________________________
Fax: ___________________________________
Date of Birth: __________________________________
Email: _________________________________
State(s) of Licensure: ____________________________
License Number(s): ________________________
Preferred Dentist Program ID Number: __________________________
Check Box If Not A PDP Member
AGD Mastership:
Yes
No
AGD Fellowship:
Yes
No
Date: _____________
Please Check One:
General Practitioner
Specialist
Dental Hygienist
Other
PLEASE PRINT CLEARLY
www.metdental.com
Please respond to the statements below by checking the appropriate box,
1 = POOR
5 = Excellent
using
the scale on the right.
1
2
3
4
5
1. How well did this course meet its stated educational objectives?
2. How would you rate the quality of the content?
3. Please rate the effectiveness of the author.
4. Please rate the written materials and visual aids used.
5. The use of evidence-based dentistry on the topic when applicable.
N/A
6. How relevant was the course material to your practice?
7. The extent to which the course enhanced your current knowledge or skill?
8. The level to which your personal objectives were satisfied.
9. Please rate the administrative arrangements for this course.
Thank you for your time and feedback.
10.
How likely are you to recommend MetLife’s CE program to a friend or colleague?
(please circle one number below:)
10
9
8
7
6
5
4
3
2
1
0
e
xtremely likely
neutral
not likely at all
What is the primary reason for your 0 - 10 recommendation rating?
11. Please identify future topics that you would like to see:
