Members of the American Association of Women Dentists (AAWD), the Smiles For Success (SFS) Foundation was formed to assist women in transition from welfare to work who cannot afford the cost of dental care.

EscaRosa Affiliate Needs Survey

The results of this survey will help EscaRosa Smiles with critical planning and grants for additional funding. No personally identifiable information will be shared with anyone. The survey should take approximately 3-5 minutes. The survey will be closed for further comments after 30 days.
EscaRosa Affiliate Needs Survey

EscaRosa Affiliate Needs Survey

Enter a number.
Enter a percentage, 1 through 100.
Enter a percentage, 1 through 100.
1 being the lowest, 10 being the highest.

 

What types of barriers do you foresee for female applicants to receive dental services?:

CHOOSE ALL THAT APPLY TO YOUR CLIENTS.

Rank the following from 1 to 10 with 0 indicating no impact:

Choose a rank, 1 through 10.
Choose a rank, 1 through 10.
Choose a rank, 1 through 10.
Choose a rank, 1 through 10.
Choose a rank, 1 through 10.
Choose a rank, 1 through 10.
Choose a rank, 1 through 10.

7794 Grow Drive
Pensacola, FL 32514
Phone (850) 474-7292
Toll Free (800) 920-2293
info@smilesforsuccess.org

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