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* 1. What is your name?

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* 2. What is your preferred email address?

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* 3. What is your preferred phone number?

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* 4. What is your main profession?

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* 5. What county do you work in?

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* 6. How did you learn about this conference?

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* 7. Age range (select one)

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* 8. Gender

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* 9. Ethnicity (select one)

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* 10. Race (select one)?

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* 11. Do you work in a primary care setting? (select one)

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* 12. Do you work in a rural community? (select one)

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* 13. Do you work in a Medically Underserved Community (MUC)? (select one)

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* 14. Overall, how would you rate the event?

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* 15. Please list topics you would like to see offered in the future.

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* 16. Do you feel the course was scientifically sound and free of commercial bias or influence? Commercial bias is defined as a personal judgment in favor of a specific product or service of a commercial interest.

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* 17. The content of this course matched my current (or potential) scope of practice.

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* 18. Overall, the speaker was knowledgeable regarding the content.

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* 19. Relevance to Practice: I believe this course will improve or positively impact my knowledge.

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* 20. Relevance to Practice: I believe this course will improve or positively impact my competence.

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* 21. Relevance to Practice: I believe this course will improve or positively impact my performance.

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* 22. Relevance to Practice: I believe this course will improve or positively impact my patient outcomes.

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* 23. Please identify how you will change your practice as a result of attending this course. Select all that apply.

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* 24. Please indicate any barriers you anticipate in implementing these changes. Select all that apply.

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* 25. By submitting this survey, I attest that I have watched the presentation in full.

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