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CME Evaluation Survey
(Tox/EM/Burn)

1.Last Name

(Required.)
2.First Name(Required.)
3.Degree(Required.)
4.What organization or Health Center are you with?(Required.)
5.Email Address(Required.)
6.Clinic Date(Required.)
Date / Time
7.Clinic Title and Learning Objectives(Required.)
8.Please select the appropriate answer(Required.)
Yes
No
Was this activity scientifically sound and free of commercial bias?
Was the program topic appropriate for your needs?
Did the program have practical clinical value?
Current Progress,
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