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* 1. Let's get some basic information.

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* 2. Do you currently hold or have you ever held a leadership position within ADHA (national, state, or local)? If so, when?

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* 3. Which platforms are you comfortable with us sharing your photo and/or excerpts from your responses?
Select all that apply.

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* 4. Please upload a photo of yourself.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File

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* 5. How long have you been a member and what inspired you to join ADHA?
(Please provide 3 - 5 sentences)

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* 6. What do you love most about being a dental hygienist?
(Please provide 3 - 5 sentences)

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* 7. What is your most memorable patient experience? (funny story, helpful story, made a difference story, etc.)
(Please provide 3 - 5 sentences)

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* 8. How do you define success?
(Please provide 3 - 5 sentences)

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* 9. What’s the best piece of career advice you’ve ever received?
(Please provide 3 - 5 sentences)

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