Dental Products Trial, Awareness
& Penetration Study (DPTAP)
SUBSCRIPTION FORM, 2008

Total Report(s) Invoice Cost:	$
N.J. business residents please add 6% state sales tax:	$
TOTAL COST:	$

I would like to reserve an annual subscription to the Dental Products Trial, Awareness & Penetration Study (DPTAP) for the following direct to dentists product categories:

Bleaching Systems* Glass Ionomer/ Compomer Filling Materials Bonding Agents Handpieces Burs - Carbide Implant Systems* Burs - Diamond Impression Material - Bite Registration Composites - Flowable Impression Material - Vinyl Polysiloxane Composites - Hybrid/Universal Resin Cements Composites - Hybrid/Universal (Posterior Packable) Temporary Crowns & Bridge Materials Composites - Microfill           Full Report Excel Format - Full Report Proprietary Question(s) Excel Format - Individual

Other Categories may be available upon request.

* This category is not part of the Full Report. It is priced separately as a single category.

Proprietary Question(s) in Detail:

An annual subscription encompasses two semi-annual reports available at the following pricing structure:

First Category - $10,307 Full Report - $21,653 Second Category - $14,845 Proprietary Question(s) - $10,307 Third Category - $19,038

DPTAP data can be obtained in Excel format at an additional cost: Full Report $1,976/yr.; Individual category grouping at $1,010/yr.

Subscription Period: First Half Second Half   1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007  TO  First Half Second Half   1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 Company Name: Street Address: City/State/Zip:      Telephone: Fax: E-Mail: Agreed for by: Title: Please feel free to call for additional information before ordering. NOTE: These reports are provided strictly to SDM’s customers for analysis of their competitive business performance and should be treated as confidential documentation. They are for our customers internal company use only and should never be shared with third parties; used for advertising purposes; or reproduced in a format other than originally published. Permission must be sought from SDM for any use of the data/reports other than in its published state and intended use. All reports are copyrighted and may not be reproduced in total or in part without explicit written permission from Strategic Dental Marketing, Inc.