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Great Lakes Seminars Customer Feedback Survey
RequiredRequired Question(s)
Progress: 
 
1.

Last name, first name (optional):

 

50 characters left.
Required 2.

Please enter the information indicated below.


State/Province
(US/Canada):
Postal Code:

Required 3.

Please list your credentials.

 

50 characters left.
4.

Optional demographic information:

Male
Female
Required 5.

Are you a member of your state Physical Therapy board?

Yes
No
Required 6.

How did you hear about this course? 



Course Booklet
Website
PT Advance
Brochure/Post card by mail
Friend/Co-worker
Other  
Required 7.

How did you register for this course?

Over the phone
By fax
Through your website
By mail
Required 8.

Please rate the following: 

I found the registration method I used to be efficient.

Strongly agree Agree Disagree Strongly disagree