Multi-DEMENTIA-Nal℠ Planning A-Z

It is our mission to provide our attendees with quality information regarding protection in times of prosperity, security in times of uncertainty, and comfort in times of crisis. We are constantly searching for ways to improve and value your feedback. Please take a few moments to complete this brief survey.

By participating in the webinar and submitting your completed survey, you are eligible for a 50% discount on your initial consultation with the Elder Law & Life Care Planning Center. Please note the discount is valid for a limited time and must be redeemed within 30 days from the date of the survey completion. Submission of the survey form is required.

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* 1. Please enter your contact information

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* 2. Marital Status

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* 3. How did you hear about our web series? Please check all that apply.

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* 4. Is this your first Elder Law & Life Care Planning Center presentation?

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* 5. Would you like to receive our weekly email newsletter?

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* 6. If you would like to schedule an initial consultation with one of our attorneys, please select your preference for follow up:

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* 7. How would you best describe your health?

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* 8. Legal Issues that interest me. Please check all that apply:

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* 9. On a scale of 1 (poor) to 5 (best), please rate the effectiveness of the presenter/event based on your personal opinion.

  1 2 3 4 5
Presenter rapport with participants:
Amount of information presented:
Amount of new information:
Overall satisfaction with presentation:
Overall satisfaction with event registration:
Functionality of technology:

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* 10. Suggestions?

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