Survey : Questions

1.	Name:
	50 characters left.

2.

Occupation:

MD

PA

APRN

RN

LPN

Other

3.

Are you requesting CME or CEU's?

Yes

No

4.

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

Credit Card/Paypal (Single Registration)

Check (Single Registration)

Credit Card/Paypal (Full Series Registration)

Check (Full Series Registration)

5.	Practice/Organization:
	50 characters left.

6.	Mailing Address:
	350 characters left.

7.

CONTENT

8.

TRAINER

	Strongly Agree	Agree	Disagree	Strongly Disagree
Knows and understands the topic
Was well organized and prepared
Was clear and easy to follow

9.

RELEVANCE - as a result of this training...

	Strongly Agree	Agree	Disagree	Strongly Disagree
I gained factual information
I gained a better understanding of topic
I have developed more skills and competencies

10.	Suggestions for improvements:
	1000 characters left.

11.	Suggestions for Future Topics:
	1000 characters left.

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
Familiar with the science of pharmacogenomics and how to understand the basis for genomic panels.
Familiar with how to best interpret the results of pharmacogenomics testing in terms of relevant applications and limitations.

Comment:
500 characters left.

13.

Required for Physicians, PA's, APRN's, Requesting CME's

Please Rate the Following Statements

	Strongly Agree	Agree	Disagree	Strongly Disagree
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

Comment:
500 characters left.

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