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?

Were the following objectives met?

Explain the concept of cancer disparities and what social factors reinforce differences among underserved populations

Yes

No

I don't know

Were the following objectives met?

Examine a community development model that promotes the implementation of cancer prevention interventions

Yes

No

I don't know

Were the following objectives met?

Explore community-based research studies that lead to reductions of cancer mortality among minority populations

Yes

No

I don't know

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

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