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

Profession

How many credit hours did you complete?

Credit Hours (maximum: 4.0)

Agreement

By completing this form, you attest that you have attended the number of hours you have indicated above.

I agree

Was the educational content of value to you?

Very Valuable

Average

Waste of time

Was the educational content scientifically sound?

Yes

No

If no, please explain...

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

Yes

No

If yes, please explain...

After attending this ISHLT Academy, were the following educational objectives met?

Understand the role of the Transplant and MCS Coordinator and how to evaluate, mange, and care for patients for the short term and long term within this role.

Yes

No

Recognize and appreciate challenges with patients with special needs and identify strategies to implement quality care for all patients.

Yes

No

Identify patient needs at the end of life, how to meet these needs and how to practice self-care.

Yes

No

If no, why not...

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

Yes

No

If yes, how...

Tell us what was good or bad about the content of this educational activity (i.e. slides, materials, speakers).

What topics would you like to see addressed in future meetings?

PHARMACISTS: If you do not provide your NABP ID AND your DATE OF BIRTH, your hours will not be uploaded to CPE Monitor.

(CPE Monitor) NABP e-Profile ID (ePID) - Example 123456:

(CPE Monitor) Date of Birth (MM/DD) - Example September 24 would be 0924:

Additional Comments: