COS 2021: CME Evaluation & Claim Form Survey

Physicians, in order to receive Category 1 credit, please complete this evaluation survey and electronically sign the CME Claim Form at the end of the survey. Information obtained from you regarding the impact of the sessions in meeting your learning needs or practice gaps is critical to the development of future educational programs. Please take the time to complete this evaluation form as completely as possible. Thank you for your valuable feedback!

	Agree	Neutral	Disagree
The program met my expectations.	The program met my expectations. Agree	The program met my expectations. Neutral	The program met my expectations. Disagree	The program met my expectations.	The program met my expectations.
The program met my educational needs.	The program met my educational needs. Agree	The program met my educational needs. Neutral	The program met my educational needs. Disagree	The program met my educational needs.	The program met my educational needs.
I learned skills and concepts that will help me be more effective and strategic in my work.	I learned skills and concepts that will help me be more effective and strategic in my work. Agree	I learned skills and concepts that will help me be more effective and strategic in my work. Neutral	I learned skills and concepts that will help me be more effective and strategic in my work. Disagree	I learned skills and concepts that will help me be more effective and strategic in my work.	I learned skills and concepts that will help me be more effective and strategic in my work.
The program provided me with new ideas, information and/or resources.	The program provided me with new ideas, information and/or resources. Agree	The program provided me with new ideas, information and/or resources. Neutral	The program provided me with new ideas, information and/or resources. Disagree	The program provided me with new ideas, information and/or resources.	The program provided me with new ideas, information and/or resources.
The presentations were commercially unbiased and fair.	The presentations were commercially unbiased and fair. Agree	The presentations were commercially unbiased and fair. Neutral	The presentations were commercially unbiased and fair. Disagree	The presentations were commercially unbiased and fair.	The presentations were commercially unbiased and fair.
The scientific presentations showed knowledge and applicability of material.	The scientific presentations showed knowledge and applicability of material. Agree	The scientific presentations showed knowledge and applicability of material. Neutral	The scientific presentations showed knowledge and applicability of material. Disagree	The scientific presentations showed knowledge and applicability of material.	The scientific presentations showed knowledge and applicability of material.

Agree

Neutral

Disagree

The program met my expectations.

The program met my expectations. Agree

The program met my expectations. Neutral

The program met my expectations. Disagree

The program met my expectations.

The program met my educational needs.

The program met my educational needs. Agree

The program met my educational needs. Neutral

The program met my educational needs. Disagree

The program met my educational needs.

I learned skills and concepts that will help me be more effective and strategic in my work.

I learned skills and concepts that will help me be more effective and strategic in my work. Agree

I learned skills and concepts that will help me be more effective and strategic in my work. Neutral

I learned skills and concepts that will help me be more effective and strategic in my work. Disagree

I learned skills and concepts that will help me be more effective and strategic in my work.

The program provided me with new ideas, information and/or resources.

The program provided me with new ideas, information and/or resources. Agree

The program provided me with new ideas, information and/or resources. Neutral

The program provided me with new ideas, information and/or resources. Disagree

The program provided me with new ideas, information and/or resources.

The presentations were commercially unbiased and fair.

The presentations were commercially unbiased and fair. Agree

The presentations were commercially unbiased and fair. Neutral

The presentations were commercially unbiased and fair. Disagree

The presentations were commercially unbiased and fair.

The scientific presentations showed knowledge and applicability of material.

The scientific presentations showed knowledge and applicability of material. Agree

The scientific presentations showed knowledge and applicability of material. Neutral

The scientific presentations showed knowledge and applicability of material. Disagree

The scientific presentations showed knowledge and applicability of material.

Excellent

Good

Neutral

Fair

Poor

Excellent

Good

Neutral

Fair

Poor

Excellent

Good

Neutral

Fair

Poor

Excellent

Good

Neutral

Fair

Poor

	Agree	Neutral	Disagree
I would prefer fewer days of meetings, but have longer hours.	I would prefer fewer days of meetings, but have longer hours. Agree	I would prefer fewer days of meetings, but have longer hours. Neutral	I would prefer fewer days of meetings, but have longer hours. Disagree	I would prefer fewer days of meetings, but have longer hours.	I would prefer fewer days of meetings, but have longer hours.
I would prefer fewer days of meetings, but keep the current hours.	I would prefer fewer days of meetings, but keep the current hours. Agree	I would prefer fewer days of meetings, but keep the current hours. Neutral	I would prefer fewer days of meetings, but keep the current hours. Disagree	I would prefer fewer days of meetings, but keep the current hours.	I would prefer fewer days of meetings, but keep the current hours.
I think the schedule is just fine as it is currently .	I think the schedule is just fine as it is currently . Agree	I think the schedule is just fine as it is currently . Neutral	I think the schedule is just fine as it is currently . Disagree	I think the schedule is just fine as it is currently .	I think the schedule is just fine as it is currently .

Agree

Neutral

Disagree

I would prefer fewer days of meetings, but have longer hours.

I would prefer fewer days of meetings, but have longer hours. Agree

I would prefer fewer days of meetings, but have longer hours. Neutral

I would prefer fewer days of meetings, but have longer hours. Disagree

I would prefer fewer days of meetings, but have longer hours.

I would prefer fewer days of meetings, but keep the current hours.

I would prefer fewer days of meetings, but keep the current hours. Agree

I would prefer fewer days of meetings, but keep the current hours. Neutral

I would prefer fewer days of meetings, but keep the current hours. Disagree

I would prefer fewer days of meetings, but keep the current hours.

I think the schedule is just fine as it is currently .

I think the schedule is just fine as it is currently . Agree

I think the schedule is just fine as it is currently . Neutral

I think the schedule is just fine as it is currently . Disagree

I think the schedule is just fine as it is currently .

COS 2021: CME Evaluation & Claim Form

Section I: Overall Program Evaluation

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* 1. Please enter your name.

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* 2. Please enter your clinic/organization name

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* 3. Please enter your city and state

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* 4. Regarding overall program effectiveness, please rate the following statements.

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* 5. The overall quality of the conference was:

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* 6. The location was:

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* 7. Pertaining to this year's topics, are there barriers to implementing what you learned that still need to be addressed?

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* 8. What topics or skills would you like to see covered at future meetings?

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* 9. Please share comments about specific speakers, ways we can improve the meeting, or any other comments you might have.

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* 10. Regarding the meeting scheule, please rate the following statements.

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* 11. What is the primary reason you attend the COS Annual Meeting?