Your Input on Our Virtual Study Club Question Title * 1. Which topics would you find most valuable for future discussions? (ranked in order of preference) 1ClinicalMove up ClinicalMove down Clinical2Practice ManagementMove up Practice ManagementMove down Practice Management3Operations/TechnologyMove up Operations/TechnologyMove down Operations/Technology4Leadership ManagementMove up Leadership ManagementMove down Leadership Management5OtherMove up OtherMove down Other Question Title * 2. Other (specified) Question Title * 3. How would you prefer the meetings to be structured? (Rank in order of preference) 1Participant Lead DiscussionMove up Participant Lead DiscussionMove down Participant Lead Discussion2Expert Speaker/Presentation-led sessionsMove up Expert Speaker/Presentation-led sessionsMove down Expert Speaker/Presentation-led sessions3A combination of both participant-led discussions and speaker presentationsMove up A combination of both participant-led discussions and speaker presentationsMove down A combination of both participant-led discussions and speaker presentations4Other(specify)Move up Other(specify)Move down Other(specify) Question Title * 4. Other (specified) Question Title * 5. How frequently would you prefer to meet? Monthly Twice annually Quarterly Annually Other (please specify) Question Title * 6. If you are interested in learning more about becoming an E2E Dental Coaching client? Yes I am already a client :) No Question Title * 7. If yes, please fill out the info below: Name Company Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Country Email Address Phone Number Next
