1 Start 2 Complete Was disclosure of faculty relationships with commercial entities made to the audience prior to the start of the activity? * Yes No I was not there prior to the start of the activity Activity met the stated purpose/objective(s)? * Yes No Was there any evidence of bias in the activity/session? * Yes No If yes, please specify * Would you recommend this activity to your peers? * Definitely recommend Likely to recommend Unlikely to recommend Definitely NOT recommend Rate each speaker/author/moderator on their ability to deliver clear and actionable education * ExcellentAbove AverageAverageBelow AveragePoor Speaker Name Speaker Name - Excellent Speaker Name - Above Average Speaker Name - Average Speaker Name - Below Average Speaker Name - Poor Speaker Name Speaker Name - Excellent Speaker Name - Above Average Speaker Name - Average Speaker Name - Below Average Speaker Name - Poor Speaker Name Speaker Name - Excellent Speaker Name - Above Average Speaker Name - Average Speaker Name - Below Average Speaker Name - Poor Speaker Name Speaker Name - Excellent Speaker Name - Above Average Speaker Name - Average Speaker Name - Below Average Speaker Name - Poor Speaker Name Speaker Name - Excellent Speaker Name - Above Average Speaker Name - Average Speaker Name - Below Average Speaker Name - Poor Performance Improvement As a part of the accreditation process, we will follow up with a sample of participants 3-6 months after the activity and will cite responses to the following questions. Will you make any changes in your practice as a result of participating in this activity? * Yes No N/A If yes, what changes will you make? * If no, what will prevent you from making changes in your practice? * Additional Comments or other topics that would help you improve your performance. Leave this field blank
