Delta Dental of Virginia
Friday, November 20, 2009

Teeth on the Go 2.0 

Kit Evaluation Form

We value your comments and suggestions.  Please complete this evaluation form and use the "submit" button below.  Thank you.

Your Name:   Job Title:   School:  
Were you able to secure the Teeth on the Go 2.0 kit easily?
  
Did the kit arrive in a timely manner for your lesson?
Did the kit arrive in good condition?
Were the materials in the kit in good condition?
Were the materials in the kit useful for communicating oral hygiene to your students?
Pre-K - Grade 2  
Grades 3 - 5  
Was there a particular portion of the Teeth on the Go 2.0 program that the children responded to more positively (DVD, CD, teeth, toothbrush, books)?  If so, please tell us about it.
     
How would you rate the kit overall?    
Pre-K - 2  
Grades 3 - 5  
Comments:    
     
What recommendations do you have about the kit or its distribution?    
     
How many students did the Teeth on the Go 2.0 program reach?    
Pre-K   3rd     
K          4th     
1st        5th     
2nd           
Was the person coordinating the Teeth on the Go 2.0 kit distribution knowledgeable and courteous?
Would you recommend this kit to your colleagues?    
Pre-K - Grade 2  

Grades 3 - 5

  
Any additional comments or feedback about the Teeth on the Go 2.0 program is welcome:
  
     
   
I have checked the information and I wish to submit the evaluation form.  

Clear the form and start over.  

 

If you have any questions, contact us at 800-572-3044, Ext. 3133

  

 

© Copyright 2001-2009 Delta Dental of Virginia.
All Rights Reserved.