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* 1. Please provide your first and last name.

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* 2. Please provide your email address to receive your CME certificate electronically.

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* 3. Did you perceive any commercial bias associated with this activity?

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* 4. Please provide your current status.

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* 5. Please list one change to practice you plan to make as a result of your participation in this activity.

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* 6. Describe any barriers that may exist that would impede implementation of changes.

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* 7. Where does Kentucky rank in child maltreatment?

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* 8. It is very rare for a child to die or be permanently disabled from maltreatment the first time they are abused/neglected.

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* 9. List two triggering situations that may lead to pediatric abusive head trauma.

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* 10. Name two symptoms that may indicate possible pediatric head trauma has occured.

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* 11. How do you prefer to receive communications from KMA?

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