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

Profession

How many credit hours did you complete?

Credit Hours (maximum: 15.5)

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

Somewhat Valuable

Not at all Valuable

Was the educational content scientifically sound?

If no, Tell us how...

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

Yes

No

If yes, what...

Did this program improve your Skill or Strategy in your role or contribution as a member of the healthcare team?

If no, why not?

Do you believe your participation in this activity will positively impact your healthcare team?

Yes

No

If yes, how?

If no, why not?

The Activity met the Educational Objectives

Please Explain your choice

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

If yes, how...

Please provide us with any additional feedback related to the content, speakers, materials, venue, or other aspect of the program.

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

PHARMACIST/TECHNICIANS: 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: