Dentaltown November 2020 - 79

CONTINUING
EDUCATION
ANSWER
SHEET

Instructions: To receive credit, complete the answer sheet and mail it, along with a check or credit card
payment of $36, to: Dentaltown.com, 9633 S. 48th St., Suite 200, Phoenix, AZ 85044. You may also fax this
form to 480-598-3450 or answer the post-test questions online at dentaltown.com/tuchman-401k. This
written self-instructional program is designated for 1.5 hours of CE credit by Farran Media. You will need a
minimum score of 70 percent to receive your credits. Participants pay only if they wish to receive CE credits;
thus no refunds are available. Please print clearly. This course is available to be taken for credit Nov. 1,
2020, through its expiration on Nov. 1, 2023. Your certificate will be emailed to you within 3-4 weeks.

The Dental 401(k) Plan

CE Post-Test
1.	A	 B	 C	 D

by Mitchell Tuchman
License Number ______

______

______

______

______

______

______

______

______

______

AGD# _____________________________________________________________________________________________________

2.	A	 B	 C	 D
3.	A	 B	 C	 D
4.	A	 B	 C	 D

Name ______________________________________________________________________________________________________

5.	A	 B	 C	 D

Address ___________________________________________________________________________________________________

6.	A	 B	 C	 D

City ____________________________________________________

State ___________

ZIP ________________________

7.	A	 B	
8.	A	 B	 C	 D

Daytime phone _____________________________________________________________________________________________
Email (required for certificate) ______________________________________________________________________________

9.	A	 B	 C	 D
10.	A	 B	

o Check (payable to Dentaltown.com)

Please circle your answers.

o Credit Card (please complete the information below and sign; we accept Visa, MasterCard and American Express.)
	

Card Number ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______

	

Expiration Date - Month / Year ______ ______ / ______ ______ ______ ______

	

Signature ______________________________________________________________________ Date __________________________________________________	

Program Evaluation (required)
Please evaluate this program by circling the corresponding numbers: (5 = Strongly Agree to 1 = Strongly Disagree)
1.	 Course administration was efficient and friendly					
2.	 Course objectives were consistent with the course as advertised			
3.	 COURSE OBJECTIVE #1 was adequately addressed and achieved			
4.	 COURSE OBJECTIVE #2 was adequately addressed and achieved			
5.	 COURSE OBJECTIVE #3 was adequately addressed and achieved			
6.	 COURSE OBJECTIVE #4 was adequately addressed and achieved			
7.	 Course material was up-to-date, well-organized, and presented in sufficient depth		
8.	 Instructor demonstrated a comprehensive knowledge of the subject			
9.	 Instructor appeared to be interested and enthusiastic about the subject			
10. 	 Audio-visual materials used were relevant and of high quality				
11. 	 Handout materials enhanced course content					
12. 	 Overall, I would rate this course (5 = Excellent to 1 = Poor):				
13. 	 Overall, I would rate this instructor (5 = Excellent to 1 = Poor):				
14. 	 Overall, this course met my expectations					
Comments (positive or negative):

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_________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________
For questions, contact Director of Continuing Education Howard Goldstein at hogo@dentaltown.com.
dentaltown.com \\ NOVEMBER 2020

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http://www.Dentaltown.com http://www.dentaltown.com/tuchman-401k http://www.Dentaltown.com http://www.dentaltown.com
Dentaltown November 2020

Table of Contents for the Digital Edition of Dentaltown November 2020
