1. Dr. Ben’s sisters are named

a) Laverne and Shirley
b) Thelma and Louise
c) Sandy and Marie
d) Coco and Billie
e) None of the above

2. Dr. Ben’s favorite place on the planet other than ‘The Garnet Valley” is

a) Wildwood, NJ
b) Disneyland, CA
c) Waco,TX
d) Aspen, Colorado
e) All of the above

3. Dr. Ben was raised in Scranton, Pa. Where was he born?

a) Leavenworth, KS
b) Attica, NY
c) Represa, CA
d) Scranton, PA
e) Alcatraz,CA

4. Dr. Ben had many nicknames growing up. His mother often called him either_____ or_______.

a) Calvin or Hobbs
b) BJ or Ben Ben
c) Lacky or loser
d) Wild or crazy guy
e) Brother or king
f) None of the above

5. If Dr. Ben did not practice dentistry, he would have been a?

a) Rodeo clown
b) Singer in a rock and roll band
c) ER doctor
d) Downhill racer
e) King of the world
f) Clerk
g) Librarian

6. When Dr. Ben was growing up, relatives thought he might be suited to be a?

a) Priest
b) Rodeo clown
c) Radio announcer
d) Golfer
e) Beach bum
f) Short order cook

7. Before entering dental school, Dr. Ben worked for a

a) Record company
b) Moving company
c) Fast food restaurant
d) Collection agency for the mob
e) Modeling agency as a male model

8. While working, Dr. Ben coached a ___________ to 3 consecutive championships.

a) Guy’s hockey team
b) Girl’s soccer team
c) Guy’s boxing team
d) Girl’s softball team
e) Guy’s fencing team

9. Dr. Ben’s closest friend of almost 30 years is named?

a) Seymore
b) JoJo
c) Rocky
d) Dave
e) Constance
f) Mr. Peabody
g) Sherman

10. Dr Ben was contacted to be an advertiser by what television show?

a) Wrestle Mania
b) Mad Men
c) Dr. Oz
d) Iron Chef
e) Ellen

11. Dr. Ben loves Taylor Swift. What do they have in common?

a) They’re both great singers
b) They both have December birthdays
c) They both contribute to St. Jude Hospital regularly
d) They both play multiple instruments
e) They both hang out with super models

12. Many of Dr. Ben’s patients continue to come for care despite their
long distance. Dr. Ben’s dental practice includes patients living in
approximately how many zip codes?

a) 10
b) 15
c) 55
d) 70
e) 102

13. Everyone knows that Dr. Ben loves children. Children age 14 and under make up what percentage of his practice?
a) 5%-10%
b) 15%-17%
c) 20%-22%
d) 25%-27%
e) Greater than 30%

14. Dr. Ben once:

A) finished 2nd in his weight class free bench press competition
B) received a gold medal for writing excellence in his high school junior and senior English classes
C) scored in the 99th percentile on the dental admissions test in the category of general knowledge
D) was a finalist for a full academic college scholarship through the Knights of St. George

a) B & C
b) B & D
c) All of the above
d) None of the above

15. Dr. Ben met his wife Carol

a) In a bar-room in Mombasa
b) At a Selena Gomez Concert
c) In a hospital emergency room
d) Through a patient
e) Through an act of God!

16. When Dr. Ben isn’t tirelessly serving his patients you might find

a) In a downtown club dancing the Macarena
b) at the White House counseling the President concerning affairs of the State
c) climbing the world’s tallest mountains
d) sailing the world’s deepest seas
e) digging holes in his backyard
f) none of the above

17. Shockingly, the average duration of employment of dental personnel is 18 months. Donna and Sheri have worked with Dr. Ben approximately __ &__ years.

a) 15 & 10 years
b) 18 & 12 years
c) 20 & 15 years
d) 30 & 20 years
e) Too too long

18. Dr. Ben has never been to

a) Spain
b) Arizona
c) Mexico
d) California
e) Rhode island
f) Canada
g) Michigan
h) Utah
i) Colorado
j) Bahamas

19. Dr Ben’s patients come from all walks of life. Over the years his patients have included

a) Race car drivers
b) A professional model
c) Professional volley ball player
d) Former Miss Philadelphia
e) Professional opera singer
f) #1 & #3
g) #2 , #4 and #5 only
h) All of the above
i) None of the above

20. Growing up, Dr. Ben’s family had (2) parakeets and a cat. Their names were

a) Coco, Billie and Sandy
b) Skippy, Ringo and Patrick
c) Peter, Paul and Mary
d) Moe, Larry and Curly
e) Duey, Cheatem, and Howe
f) Kelly, Michelle and Beyonce
g) Tweety, Daffy and Sylvester
h) None of the above

21. Dr Ben loves dogs. His favorite type of dog is a

a) Great Dane
b) Boxer
c) Poodle
d) Spiker dog
e) Lab

22. Growing up, Dr. Bens’ favorite celebrity dog was

a) Benji
b) Scooby Doo
c) Lassie
d) Rin Tin Tin
e) Beethoven
f) ToTo

23. Dr Ben’s lifetime dreams include:

a) Having at winning the lottery
b) Having at least one patient become a dentist
c) retiring and living quietly with Carol in Ankeny, Iowa
d) studying Wagner’s “Der Ring Des Nibelungen”
e) having season tickets to the Metropolitan Opera
f) Raising a ton of money for St. Jude’s Children’s Hospital
g) Conversing with the President concerning healthcare unemployment and poverty in America
h) Roping, riding and wrangling in a ranch in Montana with Carol

1. Answers a, d, e f & g
2. Answers f & g
3. Answers b, f & g
4. Answers a, f & g
5. Answers a, b & f

24. Dr. Ben’s wife, Carol
a) Was a dancer in a gypsy bar
b) Was a collegiate swimmer
c) Worked for an advertising agency
d) Worked for Vogue magazine
e) Was a nurse
f) Was an only child
g) Is a Yankee fan
h) Loves Selena Gomez
i) Wants to live in San Diego

1. Answers d, e, & f
2. Answers c, d, e & g
3. Answers b, e, h & I
4. Answers e, f & i
5. All of the above

25. If you have been an adult patient in Dr, Ben’s practice for 10 years or longer you are

a) A lucky duck!
b) In the minority-most people leave before that
c) In the majority- more than 62% of adults have been in his practice that long.
d) In need of a change
e) Probably lost

To submit this form, copy and send your selections via email to: call4drben@verizon.net