ࡱ> ;=:o@  bjbj p p (*oo:::::::NV V V V j \NE" $gR: :: nnn (: : n nn:: nY6V d(0E^NN:::::$ n NND ^NN Doc D Ƶ/Chicago College of Osteopathic Medicine Office of Continuing Medical Education Activity Evaluation Document Name of Program: _______________________________________ Date:_________________________ Time:______ Location:______________________________________________ Title of Presentation:__________________ Name of Presenter:____________________________ OBJECTIVES At the conclusion of this presentation, the participant should be able to: 1. 2. 3. Please rate the followingExcellentGoodSatisfactoryFairPoorAppropriateness of the topic for your educational needsHow well the presentation objectives were metPractical value of the presentation to your daily practicePreparation and delivery of the speaker/sOverall impression of the presentation/seminarEffectiveness of learning aid used (audio-visual, etc.?) Did the presenter disclose any real or apparent Yes ___ No ___ conflicts of interest, or lack thereof? Do you feel the presentation was free of commercial bias? Yes ___ No ___ If no, please explain why ___________________________________________________ Will you incorporate this information into your clinical practice? Yes ___ No ___ How? __________________________________________________________________ _______________________________________________________________________ Comments/Suggestions for future presentations. Dk ( ) * T V W  ' ( ` f  : @ y ٶٮ|rgggggghUshTgCJaJhTg56\] hUshUshUshTg5CJhUshUs5CJhUshTgOJQJhUshTgOJQJ\hUshTg\hUshUs5OJQJ\hUs5OJQJhUshUs5OJQJhUshTg5OJQJ hUshTg hTg5\hTghTg6CJ](Dk) * V W &$d%d&d'dNOPQgdUsgdUs$a$$a$     " ' $$Ifa$ $If]$If $$Ifa$' ( ` a b c d A;;;;;$Ifkd$$Iflֈ0?#&d0(4 lad e f ;kd$$Iflֈ0?#&d0(4 la$If ;kd$$Iflֈ0?#&d0(4 la$If   ;kd$$Iflֈ0?#&d0(4 la$If   : ;kd$$Iflֈ0?#&d0(4 la$If: ; < = > ? @ ;kd$$Iflֈ0?#&d0(4 la$If@ y z { | } ~ $If~  U A??????kd$$Iflֈ0?#&d0(4 lay hTg hTg5\ A &1h:pUs/ =!"#$%$$If!vh5d55555#vd#v#v#v#v#v:V l0(5d555554a$$If!vh5d55555#vd#v#v#v#v#v:V l0(5d555554a$$If!vh5d55555#vd#v#v#v#v#v:V l0(5d555554a$$If!vh5d55555#vd#v#v#v#v#v:V l0(5d555554a$$If!vh5d55555#vd#v#v#v#v#v:V l0(5d555554a$$If!vh5d55555#vd#v#v#v#v#v:V l0(5d555554a$$If!vh5d55555#vd#v#v#v#v#v:V l0(5d555554a@@@ NormalCJ_HaJmH sH tH :@: Heading 1$@&5\@@@ Heading 2$$@&a$5\@ Heading 3L$$d%d&d'd@&NOPQ5CJOJQJ\DAD Default Paragraph FontVi@V  Table Normal :V 44 la (k(No List  *Dk)*VW "'(`abcdef   :;<=>?@yz{|}~UA00000000000000(0(000000000H 0H 0H 0H 0H 0H @0L 0H 0H 0H 0H 0H 0H 0L @0H @0H @0H @0H @0H @0H @0L @0H @0H @0H @0H @0H @0H @0L @0H @0H @0H @0H @0H @0H @0L @0H @0H @0H @0H @0H @0H @0L 0 0 0 0 0 0 0 000000000000000000kO900$`:M900M9000Z*O900O900$y  ' d  : @ ~   ?Ahj3333333t(*RTTU  "#''(_f 9@xMidwestern UniversityMidwestern UniversityMidwestern UniversityMidwestern UniversityMidwestern UniversityMidwestern UniversityMidwestern UniversityMidwestern UniversityBDohmaAPattoTgUs U "'(`abcdef   :;<=>?@yz{|}~@i @Unknowng: Times New RomanTimes New Roman5SymbolG& : Arialhelvetica7Georgia"1h {F&&!4d3QH?Us8Evaluation document, Florida Program for License RenewalMidwestern UniversityAPattoOh+'0(8 HT p |  9Evaluation document, Florida Program for License RenewalrvalƵloidwidwNormaleAPattoe2atMicrosoft Word 10.0@F#@$@צ6@צ6՜.+,D՜.+,x4 hp  ƵS&{ 9Evaluation document, Florida Program for License Renewal Title@@4_AdHocReviewCycleID_EmailSubject _AuthorEmail_AuthorEmailDisplayName_ReviewingToolsShownOnce i_Updates for CME WebsiteBDohma@midwestern.edueDohman, Brendarohm  !"#$%&'()+,-./013456789<Root Entry F^6>Data 1TableWordDocument(*SummaryInformation(*DocumentSummaryInformation82CompObjj  FMicrosoft Word Document MSWordDocWord.Document.89q