6th CCD Conference Information Survey

1. How did you hear about the conference?

How did you hear about the conference? Received brochure in the mail

Conference brochure posted at my work

Word of mouth

Attended prior CCD Conferences

Directly from one of the presenters

From a dementia association

On a newsletter

On a different website

Other source

If you selected "from a Dementia Association, on a newsletter, on a different website, or other source", please specify

2. Demographics - Please indicate your current position by checking one of the following

Demographics - Please indicate your current position by checking one of the following Geriatrician

Psychiatrist

Neurologist

Family Physician

Psychologist

Allied Health Professional

Researcher

Industry Professional

Student/Fellow

Other Medical Specialty, please specify

3. Please rate the quality of the following using the scale shown below, please select the applicable number.

	1 - Poor	2 - Fair	3 - Somewhat Good	4 - Good	5 - Excellent
Brochure	*Please rate the quality of the following using the scale shown below, please select the applicable number. Brochure 1 - Poor	Brochure 2 - Fair	Brochure 3 - Somewhat Good	Brochure 4 - Good	Brochure 5 - Excellent
Registration Process	Registration Process 1 - Poor	Registration Process 2 - Fair	Registration Process 3 - Somewhat Good	Registration Process 4 - Good	Registration Process 5 - Excellent
Conference Materials	Conference Materials 1 - Poor	Conference Materials 2 - Fair	Conference Materials 3 - Somewhat Good	Conference Materials 4 - Good	Conference Materials 5 - Excellent
Food and Beverage	Food and Beverage 1 - Poor	Food and Beverage 2 - Fair	Food and Beverage 3 - Somewhat Good	Food and Beverage 4 - Good	Food and Beverage 5 - Excellent
Venue	Venue 1 - Poor	Venue 2 - Fair	Venue 3 - Somewhat Good	Venue 4 - Good	Venue 5 - Excellent

Comments

4. Did you attend the Gala Dinner?

Did you attend the Gala Dinner? Yes (please answer question 5)

No (please answer question 6)

5. Please rate the quality of the following using the scale shown below, please select the applicable number.

	1 - Poor	2 - Fair	3 - Somewhat Good	4 - Good	5 - Excellent
Cocktail Reception before Gala Dinner	*Please rate the quality of the following using the scale shown below, please select the applicable number. Cocktail Reception before Gala Dinner 1 - Poor	Cocktail Reception before Gala Dinner 2 - Fair	Cocktail Reception before Gala Dinner 3 - Somewhat Good	Cocktail Reception before Gala Dinner 4 - Good	Cocktail Reception before Gala Dinner 5 - Excellent
Cirque Eloize	Cirque Eloize 1 - Poor	Cirque Eloize 2 - Fair	Cirque Eloize 3 - Somewhat Good	Cirque Eloize 4 - Good	Cirque Eloize 5 - Excellent
Food & Beverage	Food & Beverage 1 - Poor	Food & Beverage 2 - Fair	Food & Beverage 3 - Somewhat Good	Food & Beverage 4 - Good	Food & Beverage 5 - Excellent
Jazz Band	Jazz Band 1 - Poor	Jazz Band 2 - Fair	Jazz Band 3 - Somewhat Good	Jazz Band 4 - Good	Jazz Band 5 - Excellent
Venue	Venue 1 - Poor	Venue 2 - Fair	Venue 3 - Somewhat Good	Venue 4 - Good	Venue 5 - Excellent

Comments

6. If no, is there a specific reason as to why?

If no, is there a specific reason as to why?

7. Overall, did this conference meet your expectations?

Overall, did this conference meet your expectations? Yes

Not Sure

No

8. What did you like best/least about the event?

What did you like best/least about the event? Best
Least

9. What are the most important benefits that you acquired from attending this conference?

What are the most important benefits that you acquired from attending this conference?

10. Will you be attending the next CCD conference in 2013?

Will you be attending the next CCD conference in 2013? Yes

No

11. Have you attended prior CCD Conferences?

Have you attended prior CCD Conferences? Yes

No

12. Please indicate how we could improve this event?

Please indicate how we could improve this event?

13. What topics or speakers would you recommend for future conferences?

What topics or speakers would you recommend for future conferences? 1
2
3
4
5

14. What changes will you make to your practice as a result of attending the 6th CCD?

What changes will you make to your practice as a result of attending the 6th CCD?

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