Sarah McQueen, DMS, PA-C

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* 1. Name

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* 2. Email

BEFORE taking this educational activity, how would you rate your CONFIDENCE in your skills to do the following:
AFTER taking this educational activity, how would you rate your CONFIDENCE in your skills to do the following:

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* 13. As a result of practicing in this activity, will you make changes to your practice? (choose all that apply)

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* 14. If you indicated that you plan to make one or more changes to your practice, please select the changes you intend to make (select all that apply)

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* 15. Did this activity provide knowledge or skills/stratgies that fullfilled your educational need?

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* 16. Please provide a specific way in which this activity will impact your patient care.

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* 17. Did this activity demonstrate ways to overcome barriers to applying new skills/strategies in your practice, particulary related to your role on the healthcare team?

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* 18. If yes, how:

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* 19. Was the format of this educational activity appropriate for the content presented?

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* 20. Was this activity scientifically sound and free of commercial bias or influence?

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* 21. If you aswered "No, " please explain:

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* 22. The France Foundation would like to send you educational opportunities relevant to your practice, emailed to the address you provided. May we have your consent?

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