Post Test

HIV/AIDS One Hour Home Study

     Do to possible and/or  frequent changes in requirements established by the State of Florida regarding  AIDS education, this home study is null and void if not returned by July 2008.

How to use this answer form:
          1.  Print out this page and send it in along with payment
                (if applicable) to MECOP.
                          Mail or FAX to:

                               Medical Educational Council of Pensacola
                          8880 University Pkwy Suite C,
                          Pensacola, Florida 32514
                          FAX: (850)477-8144 
                          Phone: (850) 477-4956
           or
         2.  Submit the answers over the internet along with your credit card information.
 
*Specialty:  Other:

*Name (
as you would like it on your Certificate of Completion)
Title: (M.D., D.O., etc)     *E-mail
*Day Phone ()-    FAX ()-
*Address
*City
*State *ZIP Code -

*Method of Payment:
I will be sending in a check for $25.00
Please charge my credit card, listed below. 

Credit Card:      Visa  Master Card  American Express 

Card# Expiration Date: Amount:

Please enter your answers to the questions below:

1)                                 2)

3)                                 4)

5)                                 6)

7)                                 8)

9)                                10)

 

Program Evaluation Summary

The purposes of this form include 1) course evaluation 2) assist in identifying topics for future programs 3) fulfilling requirements for continued category 1 CME approval.

This Program:
       

Not at all

Somewhat

Very Much

Helped me maintain current abilities and/or knowledge
Helped keep me abreast of new developments
Developed new professional skills and/or knowledge
Enhanced my confidence in my professional situation
Will help me be more effective/productive
Met my expectations
Used effective methods of information transfer
Was well-conceived/organized/produced
Met its stated goal

Please take another moment to answer the questions below.  It will assist in identifying future topics for CME offerings.
Suggestions/remarks concerning this program:

Suggestions for future programs:

Please list a behavioral technique or piece of information that has changed as a result of this program:

 

Copyright © 2004   Medical Educational Council of Pensacola. All rights reserved.
8880 University Pkwy Suite C, Pensacola, Florida 32514
Phone (850)477-4956  FAX: (850)477-8144

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