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* 1. My Specialty is:

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* 2. Please rate the items listed below:

	Excellent	Good	Satisfactory	Poor
Activity met my needs	Activity met my needs Excellent	Activity met my needs Good	Activity met my needs Satisfactory	Activity met my needs Poor
Activity made me want to learn more	Activity made me want to learn more Excellent	Activity made me want to learn more Good	Activity made me want to learn more Satisfactory	Activity made me want to learn more Poor
Activity valuable to me professionally	Activity valuable to me professionally Excellent	Activity valuable to me professionally Good	Activity valuable to me professionally Satisfactory	Activity valuable to me professionally Poor
Format facilitated learning	Format facilitated learning Excellent	Format facilitated learning Good	Format facilitated learning Satisfactory	Format facilitated learning Poor
Opportunity for participation was	Opportunity for participation was Excellent	Opportunity for participation was Good	Opportunity for participation was Satisfactory	Opportunity for participation was Poor
Audiovisual was	Audiovisual was Excellent	Audiovisual was Good	Audiovisual was Satisfactory	Audiovisual was Poor
Facilities were	Facilities were Excellent	Facilities were Good	Facilities were Satisfactory	Facilities were Poor
Overall activity rating	Overall activity rating Excellent	Overall activity rating Good	Overall activity rating Satisfactory	Overall activity rating Poor
I would recommend this activity to others	I would recommend this activity to others Excellent	I would recommend this activity to others Good	I would recommend this activity to others Satisfactory	I would recommend this activity to others Poor

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* 3. C1: THE CLINICAL SIGNIFICANCE OF SLEEP QUALITY FOR ADULTS WITH PEDIATRIC-ONSET SPINAL CORD INJURY
Alicia M. January, PhD; Kathy Zebracki, PhD; Kathleen Chlan, BA; Lawrence C. Vogel, MD

	Agree Strongly	Agree	Neutral / No Opinion	Disagree	Disagree Strongly
Content valuable to me professionally	Content valuable to me professionally Agree Strongly	Content valuable to me professionally Agree	Content valuable to me professionally Neutral / No Opinion	Content valuable to me professionally Disagree	Content valuable to me professionally Disagree Strongly
Presentation well organized	Presentation well organized Agree Strongly	Presentation well organized Agree	Presentation well organized Neutral / No Opinion	Presentation well organized Disagree	Presentation well organized Disagree Strongly
Speaker was effective	Speaker was effective Agree Strongly	Speaker was effective Agree	Speaker was effective Neutral / No Opinion	Speaker was effective Disagree	Speaker was effective Disagree Strongly

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* 4. C2: PARTICIPATION TRAJECTORIES OF YOUTH WITH AND WITHOUT SPINAL CORD INJURY
Mj Mulcahey, PhD, OTR/L; Mary Slavin, PhD, PT; Lawrence C. Vogel, MD; Pengsheng Ni, PhD, MD; Alan Jette, PhD, PT

	Agree Strongly	Agree	Neutral /No Opinion	Disagree	Disagree Strongly
Content valuable to me professionally	Content valuable to me professionally Agree Strongly	Content valuable to me professionally Agree	Content valuable to me professionally Neutral /No Opinion	Content valuable to me professionally Disagree	Content valuable to me professionally Disagree Strongly
Presentation well organized	Presentation well organized Agree Strongly	Presentation well organized Agree	Presentation well organized Neutral /No Opinion	Presentation well organized Disagree	Presentation well organized Disagree Strongly
Speaker was effective	Speaker was effective Agree Strongly	Speaker was effective Agree	Speaker was effective Neutral /No Opinion	Speaker was effective Disagree	Speaker was effective Disagree Strongly

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* 5. C3: RELATIONSHIPS BETWEEN CAREGIVER CHARACTERISTICS AND PHYSICAL AND PSYCHOSOCIAL QUALITY OF LIFE AMONG YOUTH WITH SPINAL CORD INJURY
Erin H. Kelly, PhD; Anne Riordan, MA; Sara Thorpe, BA; Kathy Zebracki, PhD; Lawrence C. Vogel, MD

	Agree Strongly	Agree	Neutral /No Opinion	Disagree	Disagree Strongly
Content valuable to me professionally	Content valuable to me professionally Agree Strongly	Content valuable to me professionally Agree	Content valuable to me professionally Neutral /No Opinion	Content valuable to me professionally Disagree	Content valuable to me professionally Disagree Strongly
Presentation well organized	Presentation well organized Agree Strongly	Presentation well organized Agree	Presentation well organized Neutral /No Opinion	Presentation well organized Disagree	Presentation well organized Disagree Strongly
Speaker was effective	Speaker was effective Agree Strongly	Speaker was effective Agree	Speaker was effective Neutral /No Opinion	Speaker was effective Disagree	Speaker was effective Disagree Strongly

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* 6. C4: INTENSE PARTICIPATION MODERATES THE MENTAL HEALTH OF YOUTH WITH DISABILITIES WHO HAVE EXPERIENCED VICTIMIZATION
Michael E. Msall, FAAP, MD; Chengshi Shiu, MS, MSW, PhD; Kruti Acharya, FAAP, MD; Kristin Berg, MSW, PhD

	Agree Strongly	Agree	Neutral /No Opinion	Disagree	Disagree Strongly
Content valuable to me professionally	Content valuable to me professionally Agree Strongly	Content valuable to me professionally Agree	Content valuable to me professionally Neutral /No Opinion	Content valuable to me professionally Disagree	Content valuable to me professionally Disagree Strongly
Presentation well organized	Presentation well organized Agree Strongly	Presentation well organized Agree	Presentation well organized Neutral /No Opinion	Presentation well organized Disagree	Presentation well organized Disagree Strongly
Speaker was effective	Speaker was effective Agree Strongly	Speaker was effective Agree	Speaker was effective Neutral /No Opinion	Speaker was effective Disagree	Speaker was effective Disagree Strongly

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* 7. C5: IMPLEMENTATION OF DEPRESSION SCREENING USING THE PATIENT HEALTH QUESTIONNAIRE TO IDENTIFY AT RISK INDIVIDUALS, REFER FOR DEPRESSION MANAGEMENT PLAN, AND MONITOR EFFECTIVENESS
Kim B. Marben, DNP, RN, CPN; Courtney Marben, BS

	Agree Strongly	Agree	Neutral /No Opinion	Disagree	Disagree Strongly
Content valuable to me professionally	Content valuable to me professionally Agree Strongly	Content valuable to me professionally Agree	Content valuable to me professionally Neutral /No Opinion	Content valuable to me professionally Disagree	Content valuable to me professionally Disagree Strongly
Presentation well organized	Presentation well organized Agree Strongly	Presentation well organized Agree	Presentation well organized Neutral /No Opinion	Presentation well organized Disagree	Presentation well organized Disagree Strongly
Speaker was effective	Speaker was effective Agree Strongly	Speaker was effective Agree	Speaker was effective Neutral /No Opinion	Speaker was effective Disagree	Speaker was effective Disagree Strongly

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* 8. C6: A PROFILE OF PARTICIPATION IN ADOLESCENTS WITH CONGENITAL HEART DEFECTS AT HIGH RISK FOR RESTRICTED ENGAGEMENT
Annette Majnemer, PhD, OT; Charles V. Rohlicek, BS, PhD, FRCPC, MD, MSc; Noemi Dahan-Oliel, PhD, MSc, OT; Sean Hatzigeorgiou, BS; Barbara Mazer, MS, PhD; Desiree B. Maltais, PhD, PT; Norbert Schmitz, PhD

	Agree Strongly	Agree	Neutral /No Opinion	Disagree	Disagree Strongly
Content valuable to me professionally	Content valuable to me professionally Agree Strongly	Content valuable to me professionally Agree	Content valuable to me professionally Neutral /No Opinion	Content valuable to me professionally Disagree	Content valuable to me professionally Disagree Strongly
Presentation well organized	Presentation well organized Agree Strongly	Presentation well organized Agree	Presentation well organized Neutral /No Opinion	Presentation well organized Disagree	Presentation well organized Disagree Strongly
Speaker was effective	Speaker was effective Agree Strongly	Speaker was effective Agree	Speaker was effective Neutral /No Opinion	Speaker was effective Disagree	Speaker was effective Disagree Strongly

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* 9. C7:BIOMEDICAL AND SOCIAL RISKS FOR LATE ADOLESCENT FUNCTIONING AND SOCIAL PARTICIPATION AFTER PREMATURITY
Michael E. Msall, FAAP, MD; Suzy B. Winchester, MA; Mary C. Sullivan, PhD

	Agree Strongly	Agree	Neutral /No Opinion	Disagree	Disagree Strongly
Content valuable to me professionally	Content valuable to me professionally Agree Strongly	Content valuable to me professionally Agree	Content valuable to me professionally Neutral /No Opinion	Content valuable to me professionally Disagree	Content valuable to me professionally Disagree Strongly
Presentation well organized	Presentation well organized Agree Strongly	Presentation well organized Agree	Presentation well organized Neutral /No Opinion	Presentation well organized Disagree	Presentation well organized Disagree Strongly
Speaker was effective	Speaker was effective Agree Strongly	Speaker was effective Agree	Speaker was effective Neutral /No Opinion	Speaker was effective Disagree	Speaker was effective Disagree Strongly

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* 10. C8: EXAMINING THE RELATIONSHIP BETWEEN PHYSICAL FATIGUE AND PHYSICAL ACTIVITY LEVELS IN ADULTS WITH CEREBRAL PALSY ACROSS THE FUNCTIONAL SPECTRUM
Patrick G. McPhee, MSc; Laura K. Brunton, PhD, MPT; Brian W. Timmons, PhD; Todd Bentley, FAAPM&R, FRCPC, MD, MSc; Jan Willem Gorter, PhD, FRCPC, MD

	Agree Strongly	Agree	Neutral /No Opinion	Disagree	Disagree Strongly
Content valuable to me professionally	Content valuable to me professionally Agree Strongly	Content valuable to me professionally Agree	Content valuable to me professionally Neutral /No Opinion	Content valuable to me professionally Disagree	Content valuable to me professionally Disagree Strongly
Presentation well organized	Presentation well organized Agree Strongly	Presentation well organized Agree	Presentation well organized Neutral /No Opinion	Presentation well organized Disagree	Presentation well organized Disagree Strongly
Speaker was effective	Speaker was effective Agree Strongly	Speaker was effective Agree	Speaker was effective Neutral /No Opinion	Speaker was effective Disagree	Speaker was effective Disagree Strongly

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* 11. C9: ASSESSMENT OF SELF-DETERMINATION IN ADOLESCENTS WITH NEONATAL BRACHIAL PLEXUS PALSY (NBPP)
Donna Bergman, EdD; Lynnette Rasmussen, BS, OTR/L; Kate Wan-Chu Chang, MA, MS; Virginia S. Nelson, MD, MPH

	Agree Strongly	Agree	Neutral /No Opinion	Disagree	Disagree Strongly
Content valuable to me professionally	Content valuable to me professionally Agree Strongly	Content valuable to me professionally Agree	Content valuable to me professionally Neutral /No Opinion	Content valuable to me professionally Disagree	Content valuable to me professionally Disagree Strongly
Presentation well organized	Presentation well organized Agree Strongly	Presentation well organized Agree	Presentation well organized Neutral /No Opinion	Presentation well organized Disagree	Presentation well organized Disagree Strongly
Speaker was effective	Speaker was effective Agree Strongly	Speaker was effective Agree	Speaker was effective Neutral /No Opinion	Speaker was effective Disagree	Speaker was effective Disagree Strongly

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* 12. C10: NEUROPSYCHOLOGICAL AND MOTIVATIONAL CONTRIBUTIONS TO HEALTH SELF-MANAGEMENT OF PERSONS WITH CONGENITAL NEURODEVELOPMENTAL CONDITIONS
Seth Warschausky, PhD; Jacqueline Kaufman, PhD; Edward A. Hurvitz, MD

	Agree Strongly	Agree	Neutral /No Opinion	Disagree	Disagree Strongly
Content valuable to me professionally	Content valuable to me professionally Agree Strongly	Content valuable to me professionally Agree	Content valuable to me professionally Neutral /No Opinion	Content valuable to me professionally Disagree	Content valuable to me professionally Disagree Strongly
Presentation well organized	Presentation well organized Agree Strongly	Presentation well organized Agree	Presentation well organized Neutral /No Opinion	Presentation well organized Disagree	Presentation well organized Disagree Strongly
Speaker was effective	Speaker was effective Agree Strongly	Speaker was effective Agree	Speaker was effective Neutral /No Opinion	Speaker was effective Disagree	Speaker was effective Disagree Strongly

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* 13. What are the three most important things you learned from these sessions?

1)

2)

3)

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* 14. How will these sessions enhance your professional effectiveness?

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* 15. How could this CME activity be improved?

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* 16. What topics would you suggest be presented in future CME activities?

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* 17. Were the sessions presented objectively and fairly?

Yes

No (please explain)

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* 18. Was disclosure of faculty and commercial support relationships made known to you?

Yes

No (please explain)

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* 19. Was disclosure of unapproved/investigative use(s) of commercial product(s), device(s) made?

Yes

No (please explain)

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* 20. Additional Comments or Suggestions:

Thank you for your feedback