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2017 MSDA National Medicaid| Medicare|CHIP Oral Health Symposium Evaluation*

2017 National Medicaid|Medicare|CHIP Oral Health Symposium Evaluation

Question Title

* 1. In order to receive CEUs, please provide your complete contact information below.

Name:

Organization:

Address:

City:

State:

Zip:

Email Address:

Phone Number:

Question Title

* 2. Please rate your overall satisfaction with the Symposium and the Welcoming Reception:

	Excellent	Good	Fair	Poor	N/A
Overall Content	Overall Content Excellent	Overall Content Good	Overall Content Fair	Overall Content Poor	Overall Content N/A
Online Registration Process	Online Registration Process Excellent	Online Registration Process Good	Online Registration Process Fair	Online Registration Process Poor	Online Registration Process N/A
Email Communication from Planning Committee	Email Communication from Planning Committee Excellent	Email Communication from Planning Committee Good	Email Communication from Planning Committee Fair	Email Communication from Planning Committee Poor	Email Communication from Planning Committee N/A
Symposium Venue	Symposium Venue Excellent	Symposium Venue Good	Symposium Venue Fair	Symposium Venue Poor	Symposium Venue N/A
Comfort of Meeting Room(s)	Comfort of Meeting Room(s) Excellent	Comfort of Meeting Room(s) Good	Comfort of Meeting Room(s) Fair	Comfort of Meeting Room(s) Poor	Comfort of Meeting Room(s) N/A
Food	Food Excellent	Food Good	Food Fair	Food Poor	Food N/A
Knowledge and Approachability of Conference Staff	Knowledge and Approachability of Conference Staff Excellent	Knowledge and Approachability of Conference Staff Good	Knowledge and Approachability of Conference Staff Fair	Knowledge and Approachability of Conference Staff Poor	Knowledge and Approachability of Conference Staff N/A
Hotel Accommodation	Hotel Accommodation Excellent	Hotel Accommodation Good	Hotel Accommodation Fair	Hotel Accommodation Poor	Hotel Accommodation N/A
Cost of Symposium	Cost of Symposium Excellent	Cost of Symposium Good	Cost of Symposium Fair	Cost of Symposium Poor	Cost of Symposium N/A
Sunday's Welcoming Reception	Sunday's Welcoming Reception Excellent	Sunday's Welcoming Reception Good	Sunday's Welcoming Reception Fair	Sunday's Welcoming Reception Poor	Sunday's Welcoming Reception N/A