Fill in the information for the 4 sections
Click Submit to get your Certificate!
1
Please grade us on the following:
Overall quality of the meeting?
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Exceptional
Above Average
Average
Below Average
Failed
How well were the educational objectives met?
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Exceptional
Above Average
Average
Below Average
Failed
Was the educational content scientifically sound?
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Exceptional
Above Average
Average
Below Average
Failed
Was the educational content free of commercial bias?
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Exceptional
Above Average
Average
Below Average
Failed
How well did the educational sessions give a balanced view of therepeutic options, including use of generic names?
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Exceptional
Above Average
Average
Below Average
Failed
Do you believe this activity:
increased your professional knowledge
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Exceptional
Above Average
Average
Below Average
Failed
will increase your professional competence
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Exceptional
Above Average
Average
Below Average
Failed
will result in performance changes in your professional practice
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Exceptional
Above Average
Average
Below Average
Failed
was appropriate for the scope of your professional activities
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Exceptional
Above Average
Average
Below Average
Failed
will result in your ability to improve your practice
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Exceptional
Above Average
Average
Below Average
Failed
If you answered any question above with a score of average or below, please explain:
2
Please answer the following:
Was the mode of education effective for learning?
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Yes
No
Not Applicable
If faculty spoke about off-label or investigational uses of a product, was that information disclosed to you?
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Yes
No
Not Applicable
If you answered "No" to either of the above questions, please explain.
Were you solicited by sales personnel in an educational room while you attended an educational activity?
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Yes
No
Not Applicable
If you answered "Yes" to the above question, please explain.
What did you learn during this activity that you intend to integrate into your practice?
List any perceived practice "gaps" you would like further trainings focused on:
Are you interested in basic, intermediate or advanced level trainings?
What barriers might you have that would interfere with implementation of new information from this training?
How can this training be improved to impact your competence or practice?
Please list any educational needs you would like to see addressed in future programs.
Additional comments:
3
Please enter your name and email address
First Name
Last Name
Email
4
Indicate the total hours you attended the educational activity (Maximum 26.5)
Hours
5
Click the button labeled 'Submit'
Heads up! We will send you a 3-month follow up survey (to the email address above) to find out what specific learning from this activity you were able to transfer to your practice.