2024 Smile, California National Children's Dental Health Month Survey

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1. Please provide your mailing address to receive your NCDHM resource samples toolkit: (Required.)

Recipient Name:

Name of LOHP or Organization:

Mailing Address (no P.O. Boxes please):

City/Town:

State/Province:

ZIP/Postal Code

Country

E-mail Address:

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2. Were you familiar with Smile, California before this webinar? (Required.)

Yes

No

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3. Are you interested in participating in the 2024 NCDHM promotion? (Required.)

Yes

No

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4. What do you find is the most effective way to communicate with individuals in your community?

In-person

Social media

E-mail

Phone calls

Live webinars/virtual meetings

Mailings

Other (please specify)

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5. Do you have any general feedback that you’d like to share? (Required.)