7DDS Mentorship Program

7DDS is in the process of initiating a Mentorship Program for the benefit of all members. Please fill out the form below if you are interested in participating as a Mentor or Mentee. The Membership Committee will match Mentors and Mentees based on the information you provide.

We are in the midst of planning an Orientation/Meet & Greet for all participants. Thereafter, we will be holding interest-specific meetings, hopefully, on a regular basis.

If you have any questions, please contact us at the phone number or email address listed below:

Phone: 585-385-9550

Email: bherman@7dds.org

Website: https://www.7dds.org/
Name:*

First NameLast Name
Email:*
example@example.com
Address:

Street Address

CityState / Province

Postal / Zip Code
Phone Number:
Cell Phone Number:*
Are you a GP?

YesNo
Specialty:
Dental School:
Graduation Year:
For Current Residents - Residency Program and year of completion:
For Current Residents - Are you interested in general practice or a specialty?
Past Residency Programs: (please list two, including the years of completion)
Please list three Continuing Education Topics of Interest:
Dental Interests (Check all that apply)

Business of dentistryClinical skills and techniquesWomen dentistsMommy dentistsPatient relationsPeriodonticsEndodonticsProsthodonticsOrthodonticsOral/maxilla facial surgerySleep dentistry/medicinePublic healthAnesthesiologyRadiologyPediatric dentistryDental technology/ AIDentistry for people with disabilitiesOral diagnosisAcademicsOther
I'd like to participate as a:*

MentorMentee
Please list three of your hobbies:
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