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

Profession

Agreement

By completing this form, you attest that you have attended the activity in its entirety.

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?

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

Were the following objectives met?

Understand the relationship between PASRR and other nursing home requirements

Were the following objectives met?

Understand key areas of federal law and regulations that guide PASRR and Long Term Care Facilities (LTCF)

Were the following objectives met?

Understanding of real-life application regulations within the PASRR process

Were the following objectives met?

Understanding of the connection of topic with other resources accessible through the PTAC website

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?

Were questions, concerns and accommodations were addressed efficiently and in a timely manner

Additional comments, questions or concerns