Spring 2025 Geri-Series Attendance Log

At the end of the series, complete this form to let us know which lectures you attended (including both Zoom Webinar virtual lectures and/or OnDemand where you watched the recorded lecture). Attendance is required for all participants. This data helps us keep the funding for this series.

*Please select to email a copy of your submissions at the bottom of this survey

Should you have any trouble filling this out, please email nwgwec@uw.edu.

*1.What's your name (first and last)?(Required.)

*2.What's your email address?(Required.)

*3.What state are you participating from?(Required.)

*4.Please select if any of the following is true (mark all that apply):(Required.)

My employer is part of the VA

I'm a veteran

I'm a student or in a training position

I'm faculty

None of the above

5.Do you work in one of the following (mark all that apply):

Primary Care

Medically Underserved Community

Rural Area

TribalOrganization

None of the bove

*6.What Geri-Series lectures did you attend in Winter 2025?(Required.)

4/3 Grief and Loss (Wendy Lustbader, MSW)

4/10 Social Prescribing/Social Connection (Alan Siegel, MD and Teresa Tam, BA, MAPS)

4/17 Assistive/Adaptive Technology (Maria Kelley, OTR/L, ATP)

4/24 Elder Health in Indigenous Elders (Jordan “Angun” Lewis, PhD, MSW, CPG)

5/1 Age-Friendly Healthcare: Mobility (Katherine Ritchey, DO, MPH)

5/8 Aging with a Physical Disability (Ivan Molton, PhD)

5/15 Medicare 101 (Tim Smolen, MHSA)

5/22 Communicating Effectively with Older Adults (Karan Dawson, PhD)

5/29 Traumatic Brain Injury (Hilaire Thompson, PhD, ARNP, FAAN)

6/5 Depression (Stephen Thielke, MD, MS, MA)

*7.Attendance Attestation(Required.)

I certify that the attendance recorded in this document is accurate and true.

*8.I have earned 1.5 hours per lecture (either attended live or watched the recording online). The total hours I have earned is:(Required.)

9.Please provide any feedback you have regarding the administration of this series?

*Below please select to email a copy of your submissions at the bottom of this survey. You can only submit this survey once.

Send me a copy of my responses via email

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