Evaluation Form

Your feedback is important to us and will help us improve future symposiums. Please complete this brief evaluation form.
* Mandatory field
Please ensure to input your full and correct name for CME accreditation
First Name*
Last Name *
Email Address*
Member of *
Registration Number*
1. Prior to this symposium, what was your level of interest in the following topics? *
No interest at allSlightly interestedFairly interestedHighly interestedExtremely interested
No interest at all
Slightly interested
Fairly interested
Highly interested
Extremely interested
No interest at allSlightly interestedFairly interestedHighly interestedExtremely interested
No interest at all
Slightly interested
Fairly interested
Highly interested
Extremely interested
No interest at allSlightly interestedFairly interestedHighly interestedExtremely interested
No interest at all
Slightly interested
Fairly interested
Highly interested
Extremely interested

2. To what extent did this symposium increase your understanding/awareness of the following topics? *
No increase at allSlightly increasedFairly increasedHighly increasedExtremely increased
No increase at all
Slightly increased
Fairly increased
Highly increased
Extremely increased
No increase at allSlightly increasedFairly increasedHighly increasedExtremely increased
No increase at all
Slightly increased
Fairly increased
Highly increased
Extremely increased
No increase at allSlightly increasedFairly increasedHighly increasedExtremely increased
No increase at all
Slightly increased
Fairly increased
Highly increased
Extremely increased

3. To what extent have the following topics impacted your clinical practice? *
No impact at allSlightly impactedFairly impactedHighly impactedExtremely impacted
No impact at all
Slightly impacted
Fairly impacted
Highly impacted
Extremely impacted
No impact at allSlightly impactedFairly impactedHighly impactedExtremely impacted
No impact at all
Slightly impacted
Fairly impacted
Highly impacted
Extremely impacted
No impact at allSlightly impactedFairly impactedHighly impactedExtremely impacted
No impact at all
Slightly impacted
Fairly impacted
Highly impacted
Extremely impacted

4. How satisfied were you with the content of this symposium?*
Not satisfiedSlightly satisfiedFairly satisfiedHighly satisfiedCompletely satisfied
Not satisfied
Slightly satisfied
Fairly satisfied
Highly satisfied
Completely satisfied

5. Do you have any other comments?

Thank you very much for your participation!