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AMEDCOT - 9th Annual Conference
Mr pencil

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



How many credit hours did you complete?
Agreement
By completing this form, you attest that you have attended the number of hours you have indicated above.
CHES MEMBERS ONLY -- Please enter your CHES ID#
Only Florida licensees need to answer this question. Notice to Florida Licensees: In order for us to report your hours to CE Broker, you MUST provide us with your Florida alpha-numberic license number (e.g., CDCA.XXXXXX, LICDCII.XXXXXX, LCDCII.XXXXXX, LICDC.XXXXXX). Please be sure to enter this number accurately, or CE Broker will not record your hours. 
Only Ohio licensees need to answer this question. Notice to Ohio Licensees: In order for us to report your hours to CE Broker, you MUST provide us with your Ohio alpha-numeric license number (e.g., CDCA.XXXXXX, LICDCII.XXXXXX, LCDCII.XXXXXX, LICDC.XXXXXX). Please be sure to enter this number accurately, or CE Broker will not record your hours. 
Was the educational content of value to you?
Was the educational content scientifically sound?
If no, Tell us how...
Did you perceive any commercial bias or influence in the educational content?
If yes, what...
Did this activity improve your Skills or Strategy?
If yes, how...
Please tell us about any sessions you found particularly good or bad.
Please tell us about any objectives you feel we accomplished well or poorly. 
Tell us how well or poorly we met any of the educational objectives
Please tell us about any presenters you found particularly good or bad.
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 specifically did you learn during this activity that you intend to integrate into your practice?
What questions are you having in your practice that you would like to see addressed in an educational activity?

What questions have arisen in your practice for which you need answers/strategies that you can implement?

What patient/client problems or patient/client challenges do you feel you are not able to address appropriately or to your satisfaction?
What problems are your patients/clients communicating to you that need attention or follow up?

Are you interested in basic, intermediate or advanced level trainings?

What barriers might you have that would interfere with implementation of new information learned from this training?

How can this training (the overall meeting) be improved to better impact competence, performance and/or patient/client outcomes?

Additional comments:

How did you attend this course?
Mr question
Provided by amedco