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3 EVENT ONLY TEMPLATE - E-Learning Courses !
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How would you like your name to appear on your certificate?



Agreement
By completing this form, you attest that you have attended the activity in its entirety.
Please rate the following:
The program was relevant to my work.
Content matched stated objectives.
Usefulness of resources.
Quality of online learning system.
How well did the educational sessions give a balanced view of therapeutic options, including the use of generic names?
If you rated any of the above questions with 'fair,' 'poor,' 'disagree,' or 'strongly disagree' please explain in detail (e.g. session title, speaker name, situation):
Objective 1: Enter Objective here
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
Objective 2: Enter Objective here
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
Objective 3: Enter Objective here
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
Objective 4: Enter Objective here
By meeting the above objective my professional competence will increase because I have acquired new strategies to use in my practice.
By meeting the above objective my professional performance will improve because I should be able to implement the new strategies.
By meeting the above objective my patient outcomes should improve due to the implementation of newly-learned strategies.
Please answer the following:
Do you believe this activity was appropriate for the scope of your professional practice?
Was the educational content scientifically sound?
Was the mode of education effective for learning?
If you answered 'No' to any of the above questions, please explain:

Did you perceive any product/service/company/commercial bias in any educational session you attended or materials you received?

If you answered "Yes" to the above question, please detail the situation below (e.g. session title, speaker name, slide):

How much did you learn as a result of this educational program?
What specifically did you learn during this activity that you intend to integrate into your practice?
What questions have arisen in your practice for which you need answers/strategies that you can implement?
What patient problems or patient challenges do you feel you are not able to address appropriately or to your satisfaction?
What problems are your patients 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 from this training?
How could this training be improved to impact your competence or performance in practice?
Additional comments regarding the speaker or session:
Mr question