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* 1. Please enter your first and last name as you would like it to appear on your CME certificate.

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* 2. Please select your title

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* 3. What is your specialty?

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* 4. E-mail address for receiving certificate

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* 5. Did you perceive any commercial bias associated with this activity?

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* 6. If you answered yes to the previous question, please describe perceived bias.

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* 7. What new strategies will you implement as a result of your participation in this activity?  (Please check all that apply.)

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* 8. Name an outcome of ACEs related to behavior, physical or mental health:

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* 9. Describe an approach you can take to create a safe physical exam environment:

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* 10. Name one thing that high doses of ACE's can affect in the body:

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* 11. As you reflect on the concept of trauma informed care and its implementation in practice, please share your thoughts on how it may relate to your practice.  This may mean describing challenges related to implementation or AHA moments that may have resonated with you.

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* 12. What other educational content can KMA provide to support your professional development?

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