End of Life Nursing Education - Day 1 CLASS EVALUATION: April 29, 2019

End of Life Nursing Education - Day 1 class evaluation: Demographics

This survey functions as the evaluation for the TCHP End of Life Nursing Education - Day 1 class. Your certificate of attendance will be sent to you at the email address you enter below.

Question Title

* 1. Please let us know a little bit about you.

The demographic information on this page is used to prepare your certificate of attendance. Evaluation responses are grouped with identifying information removed for your privacy.

*First and Last Name: *

*Email Address
(use work email if from a TCHP Organization) *

Phone:

Question Title

* 2. Please indicate which organization you work for:

Question Title

* 3. Please indicate your unit or work area. If you are not currently working, enter "not working."

Question Title

* 4. How long have you been working in health care?

Just starting

1-5 years

6-10 years

>than 10 years

Question Title

* 5. Are you currently working in hospice?

No.

Just starting.

Yes. Indicate the number of years in hospice care below

Years worked in hospice care

Question Title

* 6. Please select the situation listed below that best describes you.

I am a nurse and do not have a special certification.

I am a nurse with a special certification such as a CRRN, PCCN, etc.

I am not a nurse.

If you are not a nurse, please specify your profession

Question Title

* 7. I verify that I have attended this class.

Yes

No (not eligible for contact hours)

Question Title

* 1. Please let us know a little bit about you. The demographic information on this page is used to prepare your certificate of attendance. Evaluation responses are grouped with identifying information removed for your privacy.

Question Title

* 2. Please indicate which organization you work for:

Question Title

* 3. Please indicate your unit or work area. If you are not currently working, enter "not working."

Question Title

* 4. How long have you been working in health care?

Question Title

* 5. Are you currently working in hospice?

Question Title

* 6. Please select the situation listed below that best describes you.

Question Title

* 7. I verify that I have attended this class.

* 1. Please let us know a little bit about you.

The demographic information on this page is used to prepare your certificate of attendance. Evaluation responses are grouped with identifying information removed for your privacy.