This form comprises a maximum of 7 questions and will take fewer than 5 minutes to complete.

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* 1. Date of OHT session: 

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* 2. Name of OHT: 

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* 3. Please describe the impact of your participation on your practice based on your level of agreement with this statement:  Participation in my OHT has made a positive impact on my practice.

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* 4. Did you perceive bias in any part of the program?

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* 5. Would you like someone to contact you to discuss?

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* 6. If yes, please tell us your name and contact information

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* 7. Please share any other comments you have below:

Thank you for completing this form to provide feedback on participation in your OHT. 

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