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Continuing Education Attestation Form - Certificate of Completion
Continuing Education Attestation Form - Certificate of Completion
Are you submitting attestation for Certificate of Completion?
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Date of Event
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mm/dd/yyyy
First Name
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Last Name
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Facility Type
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Address
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City/State
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Email
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The speaker(s) presentations were clear and well organized.
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The topic of today's session is applicable to my work and will help me improve my performance.
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The program objectives/outcomes were addressed.
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Did this presentation increase your knowledge of the topic?
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Comments about overall presentation?
Describe any "pearl" or takeaway messages.
Given the scope your practice, what educational needs do you have?
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Send me a copy of my responses
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