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Breast and Cervical Cancer Screening in Marginalized Populations Webinar Evaluation (Enduring credit)
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1.
Evaluate the speaker on a scale of 1-5, with 5 being the best:
(Required.)
Heidi Gullett, MD, MPH
Met Educational Objectives
-- Select an option --
1
2
3
4
5
NA
Relevant to Practice
-- Select an option --
1
2
3
4
5
NA
Increased My Knowledge and Competence
-- Select an option --
1
2
3
4
5
NA
Speaker Was Organized and Presented Clearly
-- Select an option --
1
2
3
4
5
NA
Speaker's AV and Presentation
-- Select an option --
1
2
3
4
5
NA
Comments:
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2.
Was the speaker under undue commercial influence?
(Required.)
No
Yes - Please explain
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3.
After participating in this program, I realized I need more information on the following:
(Required.)
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4.
Identify a specific change in your practice that you intend to make as a result of the program:
(Required.)
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5.
My participation was worth the time
(Required.)
Yes
No
Comments:
6.
Please make any suggestions that would help OAFP improve the quality of our CME programs in the future:
7.
If you would like to receive additional information on the Ohio Department of Health’s Breast and Cervical Cancer Project, please provide your information below:
First Name:
Last Name:
Designation:
Email:
Role in practice (physician/social worker/admin):
Type of practice (independent practice, FQHC, LDH):
County:
8.
If you answered yes to the previous question, what information are you interested in from the Ohio Department of Health’s Breast and Cervical Cancer Project?
Provider enrollment
Referral information
Other (please specify)
