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

Profession

How many credit hours did you complete?

Credit Hours (maximum: 3.0)

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

Average

Waste of time

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, please explain...

Did this activity improve your Skills or Strategy?

Yes

No

If yes, how...

Tell us how well or poorly we met any of the educational objectives

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

Yes

No

If yes, how...

Tell us what was good or bad about any part of the educational activity, content, speakers, materials, anything

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

ABA MOCA CreditÂ® ONLY - Please answer the following:

Do you give Amedco permission to share your information with ACCME? If you answer 'no' we cannot upload your information to PARS to receive ABA MOCA Credit®.

Yes

No

Enter your 8-digit ABA ID number (e.g. 1234-5678).

Please enter your date of birth (e.g. mmdd) - Example September 24 would be entered as 0924.