Flint Dentists Feedback Survey

Please provide your feedback on how the Flint water crisis is affecting you.

Question Title

* 1. What is the level of impact-

	Minimal		Moderate		Severe
on your practice?	on your practice? Minimal	on your practice?	on your practice? Moderate	on your practice?	on your practice? Severe
on your patients?	on your patients? Minimal	on your patients?	on your patients? Moderate	on your patients?	on your patients? Severe
on you personally?	on you personally? Minimal	on you personally?	on you personally? Moderate	on you personally?	on you personally? Severe

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* 2. Please describe the impact.

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* 3. The MDA is discussing some options to support the Flint community. Which of the following options should we pursue? (Select all that apply.)

Make a donation to the Flint Children's Health and Development Fund.

Set up brushing stations in the schools and provide new toothbrushes/toothpaste for Flint children.

Set up a day to do fluoride varnish in the schools with volunteer dentists from the community.

Donate fluoridated water.

No action is needed.

Other

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* 4. Any other comments or suggestions?