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

Profession

What activities did you attend at the event?

Part 1

Part 2

Part 3

Agreement

By completing this form, you attest that you have participated in all selected activities in thier entirety.

I agree

Please rate the quality of the session overall.

Was the educational content of value to you?

Yes

No

If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:

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?

For ABPath credit upload, please provide the following:

ABPath ID Number:

Day and month of your date of birth, as MM/DD. Example: January 9 would be entered as 01/09: