Dentrix Customer Advisory Panel and Beta survey Question Title * 1. What type of organization do you work with? Single/solo practice 1-5 location organization 6-10 location organization 11+ location organization Question Title * 2. How long has your organization been practicing? 1-5 years 6-10 years 11-15 years 16-20 years 21-25 years 26+ years Question Title * 3. What interest do you have in helping our product team? Beta tester - I want to see and test the newest features and help Dentrix get better Customer Advisory Panel - I want to participate actively with and provide feedback to the Dentrix product team Question Title * 4. What type of areas do you serve? Metropolitan suburb rural Question Title * 5. Please fill out your contact information to be considered Name Company Address 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 Done