Conference Evaluation Form
Conference Roadmap

Select your participation type...
Physician Assistant
Nurse Practitioner

What other health care/professional
topics would you like to see presented?

What suggestions do you have to
improve the conference?

As a result of my participation in this activity, as far as the topics presented, I am better able to...
Possible "answers": 4=strongly agree, 3=agree, 2=somewhat disagree, 1=strongly disagree

a. Define physical and mental health conditions
Strongly Agree
Somewhat Disagree
Strongly Disagree

b. Identify various tests/tools used to diagnose common physical and mental health issues
Strongly Agree
Somewha Disagree
Strongly Disagree

c. Distinguish when to refer patients to specialists
Strongly Agree
Somewha Disagree
Strongly Disagree

The Overall Program Goal is...
"To provide a variety of speakers
and topics that are current and
relevant to Advanced Practice Clinicians
and that will allow them to increase
their knowledge and improve their
clinical practice."

Please let us know the following...

"I think the overall purpose/goal for
this activity was met."
Strongly Agree
Strongly Disagree

As a result of this activity,
please share at least one action
you will take to change your
professional practice/performance.


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