How would you like your name to appear on your certificate?

Profession

Agreement

By completing this form, you attest that you have attended the activity in its entirety.

I agree

Was the educational content of value to you?

Very Valuable

Average

Waste of time

Was the educational content scientifically sound?

Yes

No

Did you perceive any commercial bias or influence in the educational content?

Yes

No

If no, tell us how...

If yes, please explain...

Did this activity improve your Skills or Strategy?

Yes

No

If yes, how...

Enter your 6-digit ABIM ID#

Enter your date of birth (mm/dd) - For example: September 24 would be entered as 0924.

Tell us how well or poorly we met any of the educational objectives

Do you think what you learned will benefit you in your practice?

If yes, how...

Tell us what was good or bad about any part of the educational activity, content, speakers, materials, anything

What questions are you having in your practice that you would like to see addressed in an educational activity?