Primary Care 2021 Conference Evaluation Form

We would appreciate your opinions on the quality and usefulness of this conference. To receive proper credit for attending, all attendees must fill out this form for us to issue a certificate and to properly report credit hours for osteopathic physicians to the AOA. The AOA CCME requires that each physician certify or attest to the number of hours attended during a CME program.

Upon completion, you will receive a copy of your completed evaluation form. Once your evaluation has been verified, your certificate will be issued to you.

Fields marked with an asterisk * are required.

	Excellent	Very Good	Good	Fair	Poor
Quality of Conference
Conference Format
Quality of Lecture Materials
Quality of Audio/Visual Content
Met Stated Objectives
Will Alter My Practice Performance
Convinced Me I'm Doing the Right Thing
Will Be Relevant To My Practice
Satisfied My Expectations

	Very Important	Important	Neutral	Somewhat Important	Not Important
Content
Cost
Location
CME Credits Offered
Conference Date
Patient-Safety Requirements

Conference Evaluation Form

Conference Evaluation

Credit Attestation Section