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Great Lakes Seminars Customer Feedback Survey
Required Required 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?
2011 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