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

Profession

How many credit hours did you complete?

Credit Hours (maximum: 15.0)

Agreement

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

I agree

Please rate your satisfaction with the content and quality of the program:

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, what...

Did this program improve your competence or performance?

Yes

No

If yes, how...

If no, please explain...

What did you learn that will help you in your practice?

Were the following objectives met?

Objective 1:Â

Yes

No

Not sure

Were the following objectives met?

Objective 2:Â

Yes

No

Not sure

Were the following objectives met?

Objective 3:Â

Yes

No

Not sure

The program was up-to-date and relevant to my professional practiceÂ

Additional comments

Was the location suitable?

Yes

No

The facilities were conducive to learning

Yes

No

Not sure

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

Questions, concerns and accommodations were addressed efficiently and in a timely manner

Additional comments