A Clinical Guide to the F314 Tag
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1
. What is your occupation?
What is your occupation?
CMS Representative
Director of Nursing
Nursing Home Administrator
Nursing Home Consultant
Nursing Home Provider Organization Representative
DQA Surveyor - NERO
DQA Surveyor - NRO
DQA Surveyor - SERO
DQA Surveyor - SRO
DQA Surveyor - WRO
BTLE Consultant / Staff
BNHRC Staff
Other (please specify)
2
. What is your overall evaluation of this presentation?
What is your overall evaluation of this presentation?
3 - Exceeded my expectations
2 - Met my expectations
1 - Did not meet my expectations
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3
. How did you participate in this presentation?
How did you participate in this presentation?
In-person
Live webcast
On-demand webcast (recorded)
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4
. Please enter the date you viewed this presentation.
Please enter the date you viewed this presentation.
5
. Please rate the usefulness of the information provided.
Please rate the usefulness of the information provided.
3 - Exceeded my expectations
2 - Met my expectations
1 - Did not meet my expectations
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6
. Please rate the quality of the handouts / visuals used.
Please rate the quality of the handouts / visuals used.
3 - Exceeded my expectations
2 - Met my expectations
1 - Did not meet my expectations
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7
. Please rate the pace of the presentation.
Please rate the pace of the presentation.
3 - Exceeded my expectations
2 - Met my expectations
1 - Did not meet my expectations
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8
. Please rate the presenter:
Agree
Disagree
Presenter was organized
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Please rate the presenter: Presenter was organized Agree
Presenter was organized Disagree
Presenter was knowledgeable
Presenter was knowledgeable Agree
Presenter was knowledgeable Disagree
Presenter held my interest
Presenter held my interest Agree
Presenter held my interest Disagree
Presenter met the program goal
Presenter met the program goal Agree
Presenter met the program goal Disagree
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9
. I would benefit from more information on this topic.
I would benefit from more information on this topic.
Yes
No
10
. Additional Comments:
Additional Comments:
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