Webinar – Advocacy: CME Evaluation for PHYSICIANS ONLY

PHYSICIANS (MD or DO) - To evaluate the educational activity and receive a CME Certificate, please complete this survey.
Questions with an asterisk are mandatory.

OTHER LEARNERS - Do not complete this survey. Please click here to evaluate the educational activity and receive a Certificate of Attendance (these meet the continuing education requirements of many boards).

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* 1. I am a physician (MD or DO) and I attest that I participated in this educational activity and I am claiming credit for the following amount of time:

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* 2. Please enter your full name (as you would like it to appear on your certificate)

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* 3. Email address (please type carefully as we use this email to send your certificate)

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* 4. Do you work for the Los Angeles County Health Agency?

Yes, Department of Public Health

Yes, Department of Health Services

Yes, Department of Mental Health

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* 5. I participated in the CME activity on:

Date

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* 6. How well were these learning objectives met?

	Fully Met	Somewhat Met	Not Met	N/A
1. Explain 3 techniques for communicating a public health agenda to policymakers.	1. Explain 3 techniques for communicating a public health agenda to policymakers. Fully Met	1. Explain 3 techniques for communicating a public health agenda to policymakers. Somewhat Met	1. Explain 3 techniques for communicating a public health agenda to policymakers. Not Met	1. Explain 3 techniques for communicating a public health agenda to policymakers. N/A
2. List the key steps to organizing people in a grassroots effort.	2. List the key steps to organizing people in a grassroots effort. Fully Met	2. List the key steps to organizing people in a grassroots effort. Somewhat Met	2. List the key steps to organizing people in a grassroots effort. Not Met	2. List the key steps to organizing people in a grassroots effort. N/A
3. Describe potential roles for physicians in affecting local, state, or national health related policies.	3. Describe potential roles for physicians in affecting local, state, or national health related policies. Fully Met	3. Describe potential roles for physicians in affecting local, state, or national health related policies. Somewhat Met	3. Describe potential roles for physicians in affecting local, state, or national health related policies. Not Met	3. Describe potential roles for physicians in affecting local, state, or national health related policies. N/A

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* 7. How likely are you to change your practice after participating in this educational activity?

Very Likely

Somewhat Likely

Not Likely

N/A-not related to my practice

Very Likely

Somewhat Likely

Not Likely

N/A-not related to my practice