Rx for Prevention 2020 – Vaccine Mandates Article: Evaluation / Certificate Survey

Please complete the survey to evaluate the educational activity and receive a CME Certificate (physicians only) or a Certificate of Attendance (other learners). The Certificate of Attendance meets the continuing education requirements of many boards.
Questions with an asterisk are mandatory.

Question Title

* 1. What is your profession?

Question Title

* 2. I attest that I participated in this educational activity for the following amount of time:

Question Title

* 3. Please enter your full name (as you would like it to appear on your certificate)

Question Title

* 4. Email address (please type carefully as we use this email to send your certificate)

Question Title

* 5. Do you work for the Los Angeles County Health Agency?

Yes, Department of Public Health

Yes, Department of Health Services

Yes, Department of Mental Health

Question Title

* 6. I participated in the CME activity on:

Date

Question Title

* 7. How well were these learning objectives met?

	Fully Met	Somewhat Met	Not Met	N/A
1. Describe California’s immunization requirements for students entering pre-kindergarten (i.e., childcare), Transitional Kindergarten/Kindergarten-12th, and 7th grade.	1. Describe California’s immunization requirements for students entering pre-kindergarten (i.e., childcare), Transitional Kindergarten/Kindergarten-12th, and 7th grade. Fully Met	1. Describe California’s immunization requirements for students entering pre-kindergarten (i.e., childcare), Transitional Kindergarten/Kindergarten-12th, and 7th grade. Somewhat Met	1. Describe California’s immunization requirements for students entering pre-kindergarten (i.e., childcare), Transitional Kindergarten/Kindergarten-12th, and 7th grade. Not Met	1. Describe California’s immunization requirements for students entering pre-kindergarten (i.e., childcare), Transitional Kindergarten/Kindergarten-12th, and 7th grade. N/A
2. Identify the types of exemptions that are permitted under California’s pre-kindergarten and school immunization law .	2. Identify the types of exemptions that are permitted under California’s pre-kindergarten and school immunization law . Fully Met	2. Identify the types of exemptions that are permitted under California’s pre-kindergarten and school immunization law . Somewhat Met	2. Identify the types of exemptions that are permitted under California’s pre-kindergarten and school immunization law . Not Met	2. Identify the types of exemptions that are permitted under California’s pre-kindergarten and school immunization law . N/A
3. Identify contraindications and precautions to pediatric and adolescent vaccines required for pre-kindergarten and school attendance in California.	3. Identify contraindications and precautions to pediatric and adolescent vaccines required for pre-kindergarten and school attendance in California. Fully Met	3. Identify contraindications and precautions to pediatric and adolescent vaccines required for pre-kindergarten and school attendance in California. Somewhat Met	3. Identify contraindications and precautions to pediatric and adolescent vaccines required for pre-kindergarten and school attendance in California. Not Met	3. Identify contraindications and precautions to pediatric and adolescent vaccines required for pre-kindergarten and school attendance in California. N/A
4. List the elements that are required to be documented for medical exemptions.	4. List the elements that are required to be documented for medical exemptions. Fully Met	4. List the elements that are required to be documented for medical exemptions. Somewhat Met	4. List the elements that are required to be documented for medical exemptions. Not Met	4. List the elements that are required to be documented for medical exemptions. N/A
5. Access resources, including screening questionnaires and patient education materials.	5. Access resources, including screening questionnaires and patient education materials. Fully Met	5. Access resources, including screening questionnaires and patient education materials. Somewhat Met	5. Access resources, including screening questionnaires and patient education materials. Not Met	5. Access resources, including screening questionnaires and patient education materials. N/A

Question Title

* 8. How likely are you to change your practice after participating in this educational activity?

Very Likely

Somewhat Likely

Not Likely

N/A-not related to my practice

Very Likely

Somewhat Likely

Not Likely

N/A-not related to my practice