GI Health Webinar Evaluation

1.

 
1. Today's Date:
MM DD YYYY
Date:
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2. Child's Date of Birth
MM DD YYYY
Date:
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3. Your child's age
*
4. Please completed all sections
5. What symptom does your child have that is most concerning to you?
6. Please circle the number that is closest to how you feel
Strongly agreeAgreeNeutralDisagreeStrongly disagree
I learned information that I will be able to use
I learned something new
I will make changes because of what I learned today
The speaker was interesting
I understand what the next steps are
I would recommend the webinar to a friend
7. Other comments about the program:
8. If you have additional questions, can we contact you to answer them?