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* 1. Please enter your first and last name as you would like it to appear on your CME certificate.

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* 2. Please select your credentials:

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* 3. What is your specialty?

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* 4. E-mail address for receiving certificate:

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

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* 6. If you answered yes to the previous question, please describe perceived bias.

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* 7. Did you perceive that the content presented was inclusive of fair and balanced views?

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* 8. Did you perceive that any content presented was NOT based on current science, evidence and clinical reasoning?

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* 9. We ask that you reflect on what you heard today and list 1-2 new strategies you can implement in your practice based on your participation in this activity.

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* 10. How familiar are you with the referral process for senior services that encourage keeping seniors in their homes such as meal delivery, home/personal care, and senior employment services?

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* 11. What barriers do you perceive to implementing new strategies or treatment plans?

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* 12. What other educational content can KMA provide to support your professional development?

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