1. Please indicate your affiliation below: USA USAF USN VA PHS IHS State Federal Educational Institution Other (type in below)

2. I use the DECS website to find information on: a particular dental product continuing education reviews of the literature answers to my questions all of the above Other (type in below)

3. My primary area of interest is: materials equipment laboratory infection control readiness all of the above Other (type in below)

4. Please indicate the types of dental products you would like DECS to evaluate:

5. Please indicate the types of dental equipment you would like DECS to evaluate:

6. Please indicate any dental continuing education topics you would like to have available:

7. DECS personnel provide service in a timely manner. Strongly Agree Agree Disagree Strongly Disagree N/A

8. On a scale of 1 to 10, please rate the Dental Evaluation & Consultation Service. (1 being the lowest and 10 being the highest.) 1 (lowest rating) 2 3 4 5 6 7 8 9 10 (highest rating)

9. Please provide additional comments:

10. If you would like to be notified by e-mail when DECS posts new information on its web site, please add your e-mail:

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