Evaluation and CNE Certificate

Thank you for viewing the "HPV Epidemic:  Someone You Love" documentary online.  Please complete this evaluation and provide the requested contact information at the end.  After you submit this form, you will immediately receive your CNE certificate.  Please be prepared to print the certificate upon submitting this evaluation as you will not receive an email with the certificate.

Was the following objective met?   Explain the link between HPV virus and associated cancers in males and females.

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* 1. Was the following objective met?   Explain the link between HPV virus and associated cancers in males and females.

Was the following objective met?   Recognize the HPV vaccine as safe and effective.

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* 2. Was the following objective met?   Recognize the HPV vaccine as safe and effective.

Was the following objective met?  Explain the physical and emotional toll that cervical cancer has on it's victims and families.

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* 3. Was the following objective met?  Explain the physical and emotional toll that cervical cancer has on it's victims and families.

Was the following objective met?  Identify best practice vaccine guidelines and resources.

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* 4. Was the following objective met?  Identify best practice vaccine guidelines and resources.

Was the information current and up to date?

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* 5. Was the information current and up to date?

Was the documentary effective?

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* 6. Was the documentary effective?

Will you be able to apply the information to your daily practice?

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* 7. Will you be able to apply the information to your daily practice?

Was the information fair, balanced, and without bias?

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* 8. Was the information fair, balanced, and without bias?

Would you recommend this online activity to others?

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* 9. Would you recommend this online activity to others?

Additional comments

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* 10. Additional comments

Name

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* 11. Name

Job Title

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* 12. Job Title

Agency or Organization

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* 13. Agency or Organization

Street Address

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* 14. Street Address

City, State, Zip Code

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* 15. City, State, Zip Code

Email Address

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* 16. Email Address

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