Colgate Worldwide        colgatebsbf.com.au
Feedback Questionnaire Your feedback is important to us. Thank you for taking a few moments to complete this short questionnaire. Are you a Teacher Oral Health Professional Educator Parent   Teacher * Denotes required field   Personal Details Title :  * Select Mr Miss Ms Dr Name :  * School/Practice Name :  * School/Practice Address :  *   School/Practice City :  * Post Code :  * Phone No. : + + (to be filled in as countrycode+ area code + no.) Valid Email ID : (for eg. johnsmith@colgate.com)   Feedback Did you find the materials on the site useful? * No Moderately Very much How many students will you teach using BSBF this school year? * Please enter numeric values Please rate the following : (1 -5) * 1=Poor 2= Fair 3=Good 4=Very Good 5=Excellent Video/DVD Select 1 2 3 4 5 Teacher's Guide Select 1 2 3 4 5 Printables Select 1 2 3 4 5 Posters Select 1 2 3 4 5 Did you know about BSBF before visiting this website?* Yes No If yes, How did you first hear about BSBF? Teacher Dental Professional Colgate website Other Do you currently receive the BSBF Kits offline?* Yes No Would you like to be placed on our mailing list to receive information about our BSBF Education Kits?* Yes No In what formats, would you prefer to receive Educational materials?* Print CD/ROM Video DVD Website Any comments or suggestions for improvement? (Max words)