In order to receive your CME/CE certificate each participant is requested to complete this evaluation form as a way to assess the effectiveness of your learning. Once completed, you can print the certificate from here and the certificate will also be emailed to you. Thank you for attending the COR Conference

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* 1. Please type full NAME:

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* 2. Please enter your EMAIL

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* 3. Licensure / Credentials: Please enter as you would like it to appear on the CME/CE certificate (e.g., MD, DO, RN, etc.)

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* 4. Please ENTER todays date:

Date

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* 5. This activity was awarded 16.5 CME Credits. Please ENTER how many CME credits you are claiming below:

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* 6. Please let us know if you have improved your knowledge, competence, performance and/or patient outcomes by participating in this activity (check all that apply).

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* 7. This activitymet my personal learning objectives

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* 8. This activity was scientifically sound, evidence-based, and objective.

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