JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
SDDHA Legislative Survey
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Are you currently a member of SDDHA?
*
Yes
No
Are you interested in putting forward new legislature?
*
Yes
No
Unsure
If you are interested in putting forth new legislature, what would you like to see be brought forward?
*
Your answer
Would you support adding Silver Diamine Fluoride (SDF) placement by a hygienist without direct supervision?
*
Yes
No
Unsure
Would you support hygienists giving botox injections with appropriate training?
*
Yes
No
Unsure
Would you support dental therapy?
*
Yes
No
Unsure
Would you support hygiene administered vaccinations?
*
Yes
No
Unsure
Are you interested in being involved in SDDHA board or helping with legislation? If so, please send an email to
sddha.president@gmail.com
*
Yes
No
Unsure
Any additional thoughts or comments?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
