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ON-LINE EVALUATION FORM!

IJCAHPO REQUIREMENT:
All attendees are required to complete an
Evaluation Form to receive a CE Certificate

The Online Evaluation must be completed by
WEDNESDAY, MARCH 25 by 7:00 pm
(Allow 4 to 5 weeks to receive your CE Certificate)
Please complete the evaluation for the courses you attended!
i.e., Breakout Sessions - only complete the evaluation for those sessions you attended. General Sessions were scheduled for all attendees and should be completed by each attendee.
Thank you!
1.Please enter your first name:(Required.)
2.Please enter your last name:(Required.)
3.Please enter the email address that you used to register for this course (to receive credit):(Required.)
4.Course Number: 101
Interventional Glaucoma - Where Are We in 2026?
Speaker: Ian Conner, MD, PhD

Comments on the instructor, course, or both:
5.Course Number: 101
Instructor’s Name: Ian Conner, MD, PhD
Course Title: Interventional Glaucoma - Where Are We in 2026?

PLEASE RATE COURSE 101 WITH A NUMBER FROM 1 TO 5 (with 1 being the lowest, and 5 being the highest):
Overall I was satisfied with this course.
I would recommend this course to a colleague.
If Handout was provided it facilitated my understanding of this course.
Presentation was organized.
Presentation met the learning objectives.
RATE WITH A NUMBER FROM 1 TO 5:
6.Course Number: 101
Instructor’s Name: Ian Conner, MD, PhD
Course Title: Interventional Glaucoma - Where Are We in 2026?

Did the course contain any commercial or financial bias?
7.Course Number: 101
Instructor’s Name: Ian Conner, MD, PhD
Course Title: Interventional Glaucoma - Where Are We in 2026?

Did the instructor disclose any financial interest?
8.Course Number: 102
Instructor’s Name: David Baker, MD
Course Title: The Eye in Systemic Disease

Comments on the instructor, course, or both:
9.Course Number: 102
Instructor’s Name: David Baker, MD
Course Title: The Eye in Systemic Disease

PLEASE RATE COURSE 102 WITH A NUMBER FROM 1 TO 5 (with 1 being the lowest, and 5 being the highest):
Overall I was satisfied with this course.
I would recommend this course to a colleague.
If Handout was provided it facilitated my understanding of this course.
Presentation was organized.
Presentation met the learning objectives.
RATE WITH A NUMBER FROM 1 TO 5:
10.Course Number: 102
Instructor’s Name: David Baker, MD
Course Title: The Eye in Systemic Disease

Did the course contain any commercial or financial bias?
11.Course Number: 102
Instructor’s Name: David Baker, MD
Course Title: The Eye in Systemic Disease

Did the instructor disclose any financial interest?
12.Course Number: 103
Course Instructor: Mark Seraly, MD
Course Title: An Update on Macular Hole Surgery

Comments on the instructor, course, or both:
13.Course Number: 103
Course Instructor: Mark Seraly, MD
Course Title: An Update on Macular Hole Surgery

PLEASE RATE COURSE 103 WITH A NUMBER FROM 1 TO 5 (with 1 being the lowest, and 5 being the highest):
Overall I was satisfied with this course.
I would recommend this course to a colleague.
If Handout was provided it facilitated my understanding of this course.
Presentation was organized.
Presentation met the learning objectives.
RATE WITH A NUMBER FROM 1 TO 5:
14.Course Number: 103
Course Instructor: Mark Seraly, MD
Course Title: An Update on Macular Hole Surgery

Did the course contain any commercial or financial bias?
15.Course Number: 103
Course Instructor: Mark Seraly, MD
Course Title: An Update on Macular Hole Surgery

Did the instructor disclose any financial interest?
16.Course Number: 104
Course Instructor: Kelly Moerhle, COMT, OSC and Crystal Martinez, COMT, OCS, OSC, OSA
Course Title: The Great Ophthalmology Trivia Game!

Comments on the instructor, course, or both:
17.Course Number: 104
Course Instructor: Kelly Moerhle, COMT, OSC and Crystal Martinez, COMT, OCS, OSC, OSA
Course Title: The Great Ophthalmology Trivia Game!

PLEASE RATE COURSE 104 WITH A NUMBER FROM 1 TO 5 (with 1 being the lowest, and 5 being the highest):
Overall I was satisfied with this course.
I would recommend this course to a colleague.
If Handout was provided it facilitated my understanding of this course.
Presentation was organized.
Presentation met the learning objectives.
RATE WITH A NUMBER FROM 1 TO 5:
18.Course Number: 104
Course Instructor: Kelly Moerhle, COMT, OSC and Crystal Martinez, COMT, OCS, OSC, OSA
Course Title: The Great Ophthalmology Trivia Game!

Did the course contain any commercial or financial bias?
19.Course Number: 104 -
Course Instructor: Kelly Moerhle, COMT, OSC and Crystal Martinez, COMT, OCS, OSC, OSA
Course Title: The Great Ophthalmology Trivia Game!

Did the instructor disclose any financial interest?
20.Course Number 105 (Breakout Session)
Instructor's Name: Daniel Buerger, MD, FACS
Course Title: Should I Be Worried About This Bump on my Eye Lid?

Comments on the instructor, course or both:
21.Course Number 105 (Breakout)
Instructor's Name: Daniel Buerger, MD, FACS
Course Title: Should I Be Worried About This Bump on my Eye Lid?

PLEASE RATE COURSE 105 WITH A NUMBER FROM 1 TO 5 (with 1 being the lowest, and 5 being the highest):
Overall I was satisfied with this course.
I would recommend this course to a colleague.
If Handout was provided it facilitated my understanding of this course.
Presentation was organized.
Presentation met the learning objectives.
RATE WITH A NUMBER FROM 1 TO 5:
22.Course Number: 105 (Breakout)
Instructor's Name: Daniel Buerger, MD, FACS
Course Title: Should I Be Worried About This Bump on my Eye Lid?

Did the course contain any commerical or financial bias?
23.Course Number: 105 (Breakout)
Instructor's Name: Daniel Buerger, MD, FACS
Course Title: Should I Be Worried About This Bump on my Eye Lid?

Did the instructor disclose any financial interest?
24.Course Number 106 (Breakout) NO IJCAHPO Credit.
Instructor's Name: Kelly Moehrle, COMT, OSC and Crystal Martinez, COMT, OCS, OSC, OSA
Course Title: Artificial Fears about the COA and COT Exams

Comments on the instructor, course or both:
25.Course Number 106 (Breakout)
Course Number 106 (Breakout) NO IJCAHPO Credit.
Instructor's Name: Kelly Moehrle, COMT, OSC and Crystal Martinez, COMT, OCS, OSC, OSA
Course Title: Artificial Fears about the COA and COT Exams

PLEASE RATE COURSE 106 WITH A NUMBER FROM 1 TO 5 (with 1 being the lowest, and 5 being the highest):
Overall I was satisfied with this course.
I would recommend this course to a colleague.
If Handout was provided it facilitated my understanding of this course.
Presentation was organized.
Presentation met the learning objectives.
RATE WITH A NUMBER FROM 1 TO 5:
26.Course Number: 106 (Breakout)
Course Number 106 (Breakout) NO IJCAHPO Credit.
Instructor's Name: Kelly Moehrle, COMT, OSC and Crystal Martinez, COMT, OCS, OSC, OSA
Course Title: Artificial Fears about the COA and COT Exams

Did the course contain any commercial or financial bias?
27.Course Number: 106 (Breakout)
Course Number 106 (Breakout) NO IJCAHPO Credit.
Instructor's Name: Kelly Moehrle, COMT, OSC and Crystal Martinez, COMT, OCS, OSC, OSA
Course Title: Artificial Fears about the COA and COT Exams

Did the instructor disclose any financial interest?
28.Course Number: 107 (Breakout)
Instructor’s Name: Jay Chhablani, MD
Course Title: Advances in Ophthalmology Technology and Research

Comments on the instructor, course or both:
29.Course Number: 107 (Breakout)
Instructor’s Name: Jay Chhablani, MD
Course Title: Advances in Ophthalmology Technology and Research

PLEASE RATE COURSE 107 WITH A NUMBER FROM 1 TO 5 (with 1 being the lowest, and 5 being the highest):
Overall I was satisfied with this course.
I would recommend this course to a colleague.
If Handout was provided it facilitated my understanding of this course.
Presentation was organized.
Presentation met the learning objectives.
RATE WITH A NUMBER FROM 1 TO 5:
30.Course Number: 107 (Breakout)
Instructor’s Name: Jay Chhablani, MD
Course Title: Advances in Ophthalmology Technology and Research

Did the course contain any commercial or financial bias?
31.Course Number: 107 (Breakout)
Instructor’s Name: Jay Chhablani, MD
Course Title: Advances in Ophthalmology Technology and Research

Did the instructor disclose any financial interest?
32.Course Number 108 (Breakout)
Instructor’s Name: Ryan Williamson, MD, PhD
Course Title: A Practical Approach to Ocular Trauma

Comments on the instructor, course or both:
33.Course Number 108 (Breakout)
Instructor’s Name: Ryan Williamson, MD, PhD
Course Title: A Practical Approach to Ocular Trauma

PLEASE RATE COURSE 108 WITH A NUMBER FROM 1 TO 5 (with 1 being the lowest, and 5 being the highest):
Overall I was satisfied with this course.
I would recommend this course to a colleague.
If Handout was provided it facilitated my understanding of this course.
Presentation was organized.
Presentation met the learning objectives.
RATE WITH A NUMBER FROM 1 TO 5:
34.Course Number 108 (Breakout)
Instructor’s Name: Ryan Williamson, MD, PhD
Course Title: A Practical Approach to Ocular Trauma

Did the course contain any commerical or financial bias?
35.Course Number 108 (Breakout)
Instructor’s Name: Ryan Williamson, MD, PhD
Course Title: A Practical Approach to Ocular Trauma

Did the instructor disclose any financial interest?
36.Course Number: 109 (Breakout)
Instructor's Name: Aiden Dmitriev, MD
Course Title: The Eyes Have it: Decoding Multimodal Ophthalmic Tests

Comments on the instructor, course or both:
37.Course Number: 109 (Breakout)
Instructor's Name: Aiden Dmitriev, MD
Course Title: The Eyes Have it: Decoding Multimodal Ophthalmic Tests

PLEASE RATE COURSE 109 WITH A NUMBER FROM 1 TO 5 (with 1 being the lowest, and 5 being the highest):
Overall I was satisfied with this course.
I would recommend this course to a colleague.
If Handout was provided it facilitated my understanding of this course.
Presentation was organized.
Presentation met the learning objectives.
RATE WITH A NUMBER FROM 1 TO 5:
38.Course Number: 109 (Breakout)
Instructor's Name: Aiden Dmitriev, MD
Course Title: The Eyes Have it: Decoding Multimodal Ophthalmic Tests

Did the instructor disclose any financial interest?
39.Course Number: 109 (Breakout)
Instructor's Name: Aiden Dmitriev, MD
Course Title: The Eyes Have it: Decoding Multimodal Ophthalmic Tests

Did the course contain any commerical or financial bias?
40.Course Number: 110 (Breakout)
Instructor’s Name: Danielle Ferguson, COMT, CRA
Course Title: Urgent Eye Care Complaints and Triage

Comments on the instructor, course or both:
41.Course Number: 110 (Breakout)
Instructor’s Name: Danielle Ferguson, COMT, CRA
Course Title: Urgent Eye Care Complaints and Triage

PLEASE RATE COURSE 110 WITH A NUMBER FROM 1 TO 5 (with 1 being the lowest, and 5 being the highest):
Overall I was satisfied with this course.
I would recommend this course to a colleague.
If Handout was provided it facilitated my understanding of this course.
Presentation was organized.
Presentation met the learning objectives.
RATE WITH A NUMBER FROM 1 TO 5:
42.Course Number: 110 (Breakout)
Instructor’s Name: Danielle Ferguson, COMT, CRA
Course Title: Urgent Eye Care Complaints and Triage

Did the course contain any commerical or financial bias?
43.Course Number: 110 (Breakout)
Instructor’s Name: Danielle Ferguson, COMT, CRA
Course Title: Urgent Eye Care Complaints and Triage

Did the instructor disclose any financial interest?
44.Course Number 111 (Breakout)
Instructor’s Name: Holly Stants, MS, OTR/L, SCLV, CLVT
Course Title: Occupational Therapy Low Vision Rehabilitation...

Comments on the instructor, course or both:
45.Course Number 111 (Breakout)
Instructor’s Name: Holly Stants, MS, OTR/L, SCLV, CLVT
Course Title: Occupational Therapy Low Vision Rehabilitation...

PLEASE RATE COURSE 111 WITH A NUMBER FROM 1 TO 5 (with 1 being the lowest, and 5 being the highest):
Overall I was satisfied with this course.
I would recommend this course to a colleague.
If Handout was provided it facilitated my understanding of this course.
Presentation was organized.
Presentation met the learning objectives.
RATE WITH A NUMBER FROM 1 TO 5:
46.Course Number 111 (Breakout)
Instructor’s Name: Holly Stants, MS, OTR/L, SCLV, CLVT
Course Title: Occupational Therapy Low Vision Rehabilitation...

Did the course contain any commerical or financial bias?
47.Course Number 111 (Breakout)
Instructor’s Name: Holly Stants, MS, OTR/L, SCLV, CLVT
Course Title: Occupational Therapy Low Vision Rehabilitation..."

Did the instructor disclose any financial interest?
48.Course Number: 112 (Breakout)
Instructor’s Name: Joel Brown, MD, FACS
Course Title: Evaluation and Treatment of "The Red Eye"

Comments on the instructor, course or both:
49.Course Number: 112 (Breakout)
Instructor’s Name: Joel Brown, MD, FACS
Course Title: Evaluation and Treatment of "The Red Eye"

PLEASE RATE COURSE 112 WITH A NUMBER FROM 1 TO 5 (with 1 being the lowest, and 5 being the highest):
Overall I was satisfied with this course.
I would recommend this course to a colleague.
If Handout was provided it facilitated my understanding of this course.
Presentation was organized.
Presentation met the learning objectives.
RATE WITH A NUMBER FROM 1 TO 5:
50.Course Number: 112 (Breakout)
Instructor’s Name: Joel Brown, MD, FACS
Course Title: Evaluation and Treatment of "The Red Eye"

Did the course contain any commercial or financial bias?
51.Course Number: 112 (Breakout)
Instructor’s Name: Joel Brown, MD, FACS
Course Title: Evaluation and Treatment of "The Red Eye"

Did the instructor disclose any financial interest?
52.Course Number: 113 (Breakout)
Instructor’s Name: Robert Nelson, COT
Course Title: Workshop: Retinoscopy Fundamentals and Practical Application

Comments on the instructor, course or both:
53.Course Number: 113 (Breakout)
Instructor’s Name: Robert Nelson, COT
Course Title: Workshop: Retinoscopy Fundamentals and Practical Application

PLEASE RATE COURSE 113 WITH A NUMBER FROM 1 TO 5 (with 1 being the lowest, and 5 being the highest):
Overall I was satisfied with this course.
I would recommend this course to a colleague.
If Handout was provided it facilitated my understanding of this course.
Presentation was organized.
Presentation met the learning objectives.
RATE WITH A NUMBER FROM 1 TO 5:
54.Course Number: 113 (Breakout)
Instructor’s Name: Robert Nelson, COT
Course Title: Workshop: Retinoscopy Fundamentals and Practical Application

Did the course contain any commercial or financial bias?
55.Course Number: 113 (Breakout)
Instructor’s Name: Robert Nelson, COT
Course Title: Workshop: Retinoscopy Fundamentals and Practical Application

Did the instructor disclose any financial interest?
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