Webinar | September 21, 2017


Webinar September 21, 2017 6:00 PM – 7:00 PM Improving Care for Post-Treatment Cancer Survivors through Effective Communication and Community-Clinical Linkages Evaluation Form

Contact and CME Certificate Information:

First Name: Last Name:

Degree: AAFP ID:

Organization/Clinic Name:

Address:

City: State: Zip:

Phone: Fax:

Email:
Your Certificate will be emailed to this address.

By submitting this online application, you attest with your digital signature that you attended the CME sessions listed.

Please provide an overall rating of the following:
Scale: 5 = Strongly Agree 4=Agree 3= Neither Agree or Disagree 2=Disagree 1= Strongly Disagree
		5	4	3	2	1
1.	Did your learning from today’s session enhance your knowledge/skills for each of the stated objectives?
2.	Did you perceive any bias or promotion of a commercial interest during this activity?
	If so, please explain:
3.	Was the content up-to- date and accurate?
4.	Was the speaker prepared?
5.	Was attending this worth your time?
6.	Was the content presented in an appropriate learning format?
7.	Do you have any additional feedback for this presenter?
8.	Are there barriers that may prevent you from implanting changes suggested by today’s presentation?

This live series activity apart of the Cancer Screening Webinar Series, valid from 04/21/2017 - 12/29/2017,
has been reviewed and is acceptable for 1.0 Prescribed credit by the American Academy of Family Physicians.
Physicians should claim only the credit commensurate with the extent of their participation in the activity.