Continuing Education Evaluation

Please COMPLETE all items as requested. If not applicable, please just hit enter to continue. If you fail to provide a reliable e-mail address, we will be unable to provide your CEU.

Question Title

1. First Name?

Question Title

2. Last Name?

Question Title

3. Nursing License Number

Question Title

4. Admin ALF License Number

Question Title

5. Admin Skilled License Number

Question Title

6. Social Work License Number

Question Title

7. AADC, PT, OT or Other License Number

Question Title

8. Email Address (Non-VA or Gov)

Question Title

9. Please include your telephone number in case we need to reach you about missing or incorrect data. (XXX-XXX-XXXX)

Question Title

10. With 5 Stars the highest, how would you rate the Presentation?

Question Title

11. With 5 Stars being highest, how would you rate the Presenter?

Question Title

12. With 5 Stars being the highest, participant will be able to •Describe new ways to relate to others with different personality types

Question Title

13. With 5 Stars being the highest, will be able to •Understand the role of personality in interpersonal relations

Question Title

14. With 5 Stars being the highest, participants will be able to •Identify your own personality type and what each means.

Question Title

15. What is the CEU Word?

Question Title

16. What is the name of your current/previous employer if you are retired?

Question Title

17. Comments, Suggestions or Topics you would like to hear!

T