A Medical Practitioners Guide to Utility Law in Connecticut
1.
Name:
 

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2.
Occupation:
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3.
Are you requesting CME or CEU's?
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4.

If requesting CME/CEU, please indicate payment method:. 

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Credit Card/Paypal (Full Series Registration)
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5.

Practice/Organization:

 

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Mailing Address: 

 

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7.
CONTENT
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Was organized and easy to follow  
Met the objective(s)  
8.
TRAINER
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Knows and understands the topic  
Was well organized and prepared  
Was clear and easy to follow  
9.
RELEVANCE - as a result of this training...
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I gained factual information  
I gained a better understanding of topic  
I have developed more skills and competencies  
10.
Suggestions for improvements:
 

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11.
Suggestions for Future Topics:
 

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12.
Required for Physicians, PA's, APRN's, Requesting CME's
This was a quality CME activity and met the following objectives:
 Strongly Agree Agree Disagree Strongly Disagree  
Learning about utility law in Connecticut  
assessing eligibility for utility "medical protection" under Connecticut law  
Working with the patient and the utility companies to access appropriate supports for patients.  
  • Comment:

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13.
Required for Physicians, PA's, APRN's, Requesting CME's
Please Rate the Following Statements
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This CME activity will favorably influence my ability to practice medicine as a leader, teacher and researcher  
The program clearly indicated whether or not this CME activity received commercial support  
I observed no overall commercial bias in this educational session  
I would definitely recommend this CME activity to my colleagues  
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14.
Did the CME program communicate any conflict of interest or lack thereof?
Yes (if 'yes" please answer next question)
No
I do not recall
15.

If you answered YES to the above question, how was the conflict of interest communicated?

Promotional material
PPT slides
Introductory Remarks
Handouts
I do not recall
Other