Dental Benefits Survey

*The survey below is what all profiles must complete in order to be added to the profile database. The survey must be completed entirely, (no partially completed surveys) otherwise the profile will be rejected and not be added to the database. Once you have enrolled in the system, you will be granted access to the database. You can search the entire database using advanced filtering options to find the profiles that match your exact interests.

Q: I have an immediate or emergency dental need.

• Yes
• No

Q: Besides the Dental Plan, I am also interested in your Discount Health & Medical benefits for discounts on doctor visits and hospitalization:

• Yes
• No

Q: I am interested in benefits for:

• Me alone
• My Family

Q: I need coverage:

• Immediately
• Not Sure

Q: I would want to activate my benefit package by payment from my:

• Credit Card
• Debit Card
• Checking Account
• Savings Account
• I Don't Have Any Of These

Q: What age group are you in?

• Under 20
• 20 - 29
• 30 - 39
• 40 - 49
• 50 - 59
• 60 - 69
• 70 - 79
• 80+

Q: I would probably want to pay my membership fee:

• Monthly
• Quarterly
• Annually
• Not Sure

Q: What is your time zone?

• Newfoundland
• Atlantic
• Eastern
• Central
• Mountain
• Pacific
• Alaska
• Hawaii-Aleutian
• Guam