Program Evaluation 123456 Thank you for taking the time to complete this CME evaluation. Your feedback is very important to the program directors. You will receive your certificate as a PDF attachment via email within two (2) weeks of submission. The subject line will be "CDM 2018 Certificate". Name and degrees/credentials*Please enter your name exactly as you would like it to appear on your certificate, including degrees and/or credentials. Your evaluation answers will be kept strictly confidential. Name and degrees/credentials Email Address*You will receive your certificate as a PDF attachment via email from Promedica International within two (2) weeks of submission. The subject line will be "CDM 2018 Certificate". Enter Email Confirm Email Type of Certificate* AMA PRA Category 1 Credits Nursing CE Contact Hours Perfusion CEUs (approved by the ABCP) No Credit Needed (no certificate will be sent) Promedica International is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Promedica International designates this live activity for a maximum of 12.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.Provider approved by the California Board of Registered Nursing, Provider #8495 for 12.25 Contact Hours for the Cardiovascular Disease Management symposium. This certificate must be retained by the licensee for a period of four years after the course ends.The American Board of Cardiovascular Perfusion (ABCP) has approved a total of 14.7 Category 1 CEUs for perfusionists for Thursday, October 11 (6.6), and Friday, October 12 (8.1). Number of AMA PRA Category 1 Credit(s)™*Please note that if you are also claiming ABIM MOC points, they will be equivalent to the number of AMA PRA Category 1 Credit(s)™ claimed.Please enter a number from 1 to 12.25.Would you like to also claim ABIM MOC points for your participation?*Note: Physicians participating in the ABIM's Maintenance of Certification (MOC) program are able to claim MOC Points via this online evaluation form through March 15, 2019. It is the CME activity provider’s responsibility to submit participant completion information to the ACCME for the purpose of granting ABIM MOC credit. By claiming ABIM MOC points via this form, you authorize Promedica International (the accredited provider) to submit the hours you claimed to the ABIM on your behalf. No Yes ABIM ID*Your ABIM ID is 6 digits. If you do not know your ABIM ID, you can look it up here: https://www.abim.org/online/findcand.aspx. Date of Birth* Month Day Year Number of Contact Hours*Please enter a number from 1 to 12.25.Nursing License Number* Number of Perfusion CEUs*Please enter a number from 1 to 14.7. Overall comments on the symposiumPlease share what you have learned and will change or maintain in your practice and/or patient care as a result of this symposium. **This reflective statement is required in order to claim ABIM MOC Credits***Educational Objectives Rate how well you feel each educational objective was addressed. After attending the symposium, participants should be able to: Understand the new lipid agents and their potential impact on risk factors* Excellent Good Fair Poor Examine the serious complications of diabetes, particularly peripheral vascular disease and wound care from the perspective of a cardiovascular specialist* Excellent Good Fair Poor Compare and contrast management of the most common arrhythmia, atrial fibrillation* Excellent Good Fair Poor Understand the clinical evaluation and treatment of congestive heart failure* Excellent Good Fair Poor Recognize and evaluate patients with cardiovascular disease seen in a day-to-day practice setting, and to be able to gauge and manage therapy of these patients* Excellent Good Fair Poor Explore cardiovascular treatment options on the horizon* Excellent Good Fair Poor Understand and discuss the future of healthcare delivery in this new era* Excellent Good Fair Poor Comment Overall Program ReviewDid you hear anything in the accredited presentations that favored a specific product or company, not backed by clinical data?***If the answer is yes, it is important that you note the lecture/speaker and product concerned in the space provided. Yes No Comment October 11 & 12, 2018Thursday, October 11, 2018 - Session I*View Session I. Excellent Good Fair Poor *Did not attend Thursday, October 11, 2018 - Session II*View Session II Excellent Good Fair Poor *Did not attend Friday, October 12, 2018*View Session III. Excellent Good Fair Poor *Did not attend Friday, October 12, 2018 - Session IV*View Session IV. Excellent Good Fair Poor *Did not attend Comment Needs AssessmentYour SpecialtyYou may select more than one option if applicable. Cardiology, Clinical Cardiology, Interventional Cardiothoracic Surgery Nursing Perfusion Vascular Medicine Other Specialty Information about "other" Methods of LearningYou may select more than one option if applicable. Articles DVDs Labs Lectures Webcasting Workshops Other Methods Information about "other" Barriers to ChangeYou may select more than one option if applicable. None Funding/Equipment Hospital/Practice Support Patient Compliance Other Barriers Information about "other" Location for a meetingYou may select more than one option if applicable. Hospital Hotel Resort Other Location Information about "other" CommentsThis field is for validation purposes and should be left unchanged.
