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* 1. Please tell us your first and last name:

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* 2. CHES/MCHES number:

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* 3. If you are CHES/MCHES, please provide an email address to send your certificate

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* 4. Please rate how well the following learning objective was met: "To explore the evidence-based strategies used by the National Center on Disability in Public Health, including applications to healthcare access among people who have a disability."

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* 5. Please rate how well the following learning objective was met: "To examine key areas of health disparity among people who have a disability."

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* 6. Please rate how well the following learning objective was met: "To learn how to engage change management strategies that support inclusion and action plans that sustain change."

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* 7. Please rate how well the following learning objective was met: "To describe evaluation of health promotion efforts that include people who have a disability."

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* 8. Please rate the degree to which the session met your learning needs.

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* 9. Please rate the overall quality of this session.

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* 10. Please rate the speaker in the following areas:

  Very poor Poor Fair Good  Excellent
Knowledge of Subject Matter
Organization/ Clarity of Presentation
Useful Information
Speaker/Participant Interaction
Use of Allotted Time
Audio/Visual Aids
Handouts

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* 11. Please provide any additional comments in this space.

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