Waterpik Technologies DT400 - Manual (Page 8)

Obtaining Continuing Education Credits
Waterpik Technologies is designated as an Approved
PACE Program Provider by the Academy of General
Dentistry. The formal continuing education programs of
this provider are accepted by the AGD for Fellowship,
Mastership, and membership maintenance credits.
Approval does not imply acceptance by a state or provin-
cial board of dentistry. The current term of approval
extends from 04-05-1998-05-31-2006.
Credits: 1 hour
If you have questions about CE requirements in your state
or province, please consult your regulatory board.
Directions
• Fill out the Waterpik CE Registration Form and Answer
Sheet.
• Answers should be logged on the answer sheet. Please
make a copy of the post test and your answer sheet to
retain for your records.
• Only one original answer sheet per individual will be
accepted. PHOTOCOPIES ARE NOT VALID.
• Answers left blank will be graded as incorrect.
• Please fill out the course evaluation portion.
• Submit your answer sheet via mail to:
Carol Jahn, RDH, MS
Educational Programs Manager
Waterpik Technologies
1730 East Prospect Road
Fort Collins, CO 80553
Scoring
In order to receive credit, you must answer correctly 4
questions out of 5.
Results
Will be mailed in 6 – 8 weeks.
Questions
Please contact Carol Jahn, Education Programs Manager,
at 1.800.525.2020 x 8565 or via email at
[email protected].
CE Registration Form and Answer Sheet
Course #03-03: Power Brushes: An Effective
Alternative
Name: ______________________________________
Credentials: __________________________________
Street Address: ________________________________
City: ________________________________________
State: ________________ Zip:__________________
Daytime Phone: ______________________________
Email: ______________________________________
Answer Sheet - Please circle the correct
answer for each question.
1. a b c d
2. a b c d
3. a b c d
4. a b c d
5. a b c d
Course Evaluation – Circle your response:
1 = lowest, 5 = highest
Course objectives were met
1 2 3 4 5
Content was useful
1 2 3 4 5
Questions were relevant
1 2 3 4 5
Rate the course overall
1 2 3 4 5