Reflective Statement for 2018 Poster Symposium

You must complete this form to receive credit for the 2018 Research Symposium Poster Activity.

Question Title

* 1. Please complete the following for poster author/applicant:

Poster Presenter Name

Poster Title

Question Title

* 2. Disclosures: None of the planners of this activity have any financial relationships with commercial interests. Please check: I have submitted my financial disclosure to Natividad:

Yes, I have submitted my financial disclosure to Natividad

No, I have NOT submitted my financial disclosure to Natividad and must do so to receive credit

Learning | Answer these questions after developing your presentation

Question Title

* 3. What did you actually learn from creating this presentation?

Question Title

* 4. What will you do differently now in your practice as a result of this activity?

(e.g., more reading on the topic, new research, additional collaborations, apply learning into practice, etc.)

Please be specific!

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* 5. Other comments on this activity?

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* 6. Number of AMA PRA Category 1 Credit(s)™ to be claimed:

Upon submitting this form, you will be claiming AMA PRA Category 1 Credit™ for participating in the Natividad Medical Center's 2018 Poster Symposium. Please complete this no later than April 16, 2018.

Thank you. If you have any questions, please contact the CME Office at CME@natividad.com

Question Title

* 1. Please complete the following for poster author/applicant:

Question Title

* 2. Disclosures: None of the planners of this activity have any financial relationships with commercial interests. Please check: I have submitted my financial disclosure to Natividad:

Question Title

* 3. What did you actually learn from creating this presentation?

Question Title

* 4. What will you do differently now in your practice as a result of this activity? (e.g., more reading on the topic, new research, additional collaborations, apply learning into practice, etc.) Please be specific!

Question Title

* 5. Other comments on this activity?

Question Title

* 6. Number of AMA PRA Category 1 Credit(s)™ to be claimed:

* 4. What will you do differently now in your practice as a result of this activity?

(e.g., more reading on the topic, new research, additional collaborations, apply learning into practice, etc.)

Please be specific!