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Advisory Boards

Continuing Medical Education Evaluation Form


Current Concepts In Pharmacologic Management Of JIA
       To successfully complete the activity, you must read the monograph, complete and submit the post-test evaluation by March 31, 2009. A passing score of 70 percent is required in order to receive a certificate of credit.

Please complete this evaluation form:


Name/Degree Position/Title

Department/Organization/Institute


Street Address


City State Zip Code


E-mail address


Phone number Fax number

Please fill in your responses to the questions on page 23.

1. a Ο b Ο c Ο d Ο
2. a Ο b Ο c Ο d Ο
3. a Ο b Ο c Ο d Ο e Ο f Ο
4. a Ο b Ο c Ο d Ο e Ο f Ο
5. a Ο b Ο c Ο d Ο
6. a Ο b Ο c Ο d Ο e Ο f Ο
7. a Ο b Ο c Ο d Ο
8. a Ο b Ο c Ο d Ο e Ο
9. a Ο b Ο c Ο d Ο
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Course Evaluation: Rate on a 1-5 scale

1. Faculty was knowledgeable on the subject matter. ____
2. Content was objective. ____
3. Content was balanced. ____
4. Content avoided commercial bias or influence. ____
5. Content was timely and related to my practice. ____
6. Content will assist me in enhancing patient care. ____
7. Information presented will improve my practice/patient outcomes. ____
8. What other topics would be of interest to you? __________________________

5= Strongly agree 4= Agree 3= Neutral 2= Disagree 1= Strongly Disagree

Instructions For Submitting Exams
Participants must score at least 70 percent on the questions and complete the entire evaluation form, copy/print the entire evaluation form and send it to the address below. Certificates will be mailed to those who successfully complete the evaluation form within 12 months of the publication date. Fax the completed form to (610) 560-0501 or mail to:
Trish Levy, CME Director • 83 General Warren Boulevard, Suite 100 • Malvern, PA 19355

 


300 Rike Drive • Suite A • Millstone Township, NJ 08535 • Fax: (609) 371-2733

© 2008 NACCME - Princeton CME