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* 1. Name

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* 2. Position Title 

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* 3. Email Address

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* 4. How confident are you in your ability to perform this task? 

  Very confident Confident Somewhat confident Not at all confident Not applicable to my position
Describing the death certification process in your jurisdiction.
Identifying what qualifies as a disaster.
Determining if a death is related to a disaster.
Reporting a death that is related to a disaster.

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* 5. What is your level of knowledge on this topic? 

  Very knowledgeable  Knowledgeable Somewhat knowledgeable Not at all knowledgeable Not applicable to my position
Certifying death due to non-natural causes and fetal death
Guidance for certification of deaths in the event of a natural, human-induced, or radiological/chemical disaster

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* 6. How would you rate the overall quality of the training program?

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* 7. How much do you agree with the following statements?

  Strongly agree Agree Neutral Disagree Strongly Disagree
I was satisfied with this training overall.
My understanding of death certificates and reporting has improved as a result of this training.
There were enough opportunities for questions and discussion.
The material was presented in an engaging way.
The information was presented in ways I could clearly understand.
The presenter(s) was knowledgeable about the subject matter.
I would recommend this training to colleagues.

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* 8. Any additional comments?

Thank you for completing this survey. After clicking "Done" you will receive a link to obtain CME/CNE credits. 

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