PACCM Grand Rounds Check In 2023-2024

PACCM Grand Rounds Check In 2023-2024

Presentation Date*

Your Name*

Degree*

E-mail*

MD License Number*

License State*

Date of Birth MM/DD*

Total Hours Attended*

Commercial bias?*

Was the information/material presented free from commercial bias?

Yes

No

Did you learn new strategies that you can apply?*

If yes, please describe

Reflection (MOC II Credit)*

Please write a short reflection / written response to today's presentation (at least 25 words)

On a scale of 1-5 how effective was the speaker?

1 - Poor

2 - Fair

3 - Good

4 - Very good

5 - Excellent

Do you have any comments for the speaker?

Send me a copy of my responses

Powered by