ACPE Questions

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your email address?

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* 4. Street address:

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* 5. Street address (line 2):

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* 6. City:

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* 7. State

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* 8. Zip Code:

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* 9. Position / Title – eg. MD, RN, CRNA, DDS, etc.

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* 10. NABP ePID – (required for ACPE)

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* 11. Birthday Month (required for ACPE)

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* 12. Birthday Day (required for ACPE)

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* 13. Check all of the sessions you attended. Note: You can only select one session per time slot.

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* 14. OVERALL ANNUAL MEETING EVALUATION

  Excellent Very Good Good Fair Poor
Meeting format
Quality of information presented
Scientific rigor
Level of instruction
Fulfilled stated learning objectives
Overall objectivity and balance
Rate the appropriateness of the educational formats used during the meeting for the setting, objectives, and desired results of the meeting
Rate the likelihood you will make a change in practice behavior based on your participation in this activity

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* 15. Meeting Impact: This meeting (please indicate all that apply):

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* 16. As a result of attending this meeting, what will you do differently in your practice?

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* 17. Additional comments?

0 of 17 answered
 

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