The Office of Continuing Professional Development and TEACH

Note: You will be required to answer two questions from the video for CME credit.
The starred (*) fields require an answer.

Question Title

* 1. Name

Question Title

* 2. Title:

Question Title

* 3. Department:

Question Title

* 4. Email Address

Question Title

* 5. Date you watched

Date

Question Title

* 6. What presentation are you requesting CME credit for?

Question Title

* 7. Did you receive disclosure information at the beginning of the presentation?

Question Title

* 8. Was the speaker biased in the discussion of any product(s) or service(s)?

Question Title

* 9. Tell us two distinct things you learned.

Question Title

* 10. Based on this lecture what do you feel more competent doing?

Question Title

* 11. Based on what you learned from this lecture tell us one thing you will commit to change in your practice.

Question Title

* 12. Please rate each section.

  Excellent Very Good Acceptable Fair
Content was relevant to my needs
Objectives were accomplished
Speaker was organized
Overall Evaluation

Question Title

* 13. Question 1 from the presentation.

Question Title

* 14. Question 2 from the presentation.

Reminder!  You can access your CME report using the CME Tracker at www.carilionclinic.org/continuing-medical-education.

T