Muscular-Skeletal Pain Management in a Farmworker Population - Evaluation Form

Learning Objectives:

At the end of this webinar, participants will be able to... 1. Identify and recognize risk factors in the workplace and their relationship with musculoskeletal injuries. 2. Identify the various forms of protection and prevention of occupational injuries. 3. Recognize strategies and resources to prevent musculoskeletal injuries at work. 4. Identify how to address pain and pain management in a primary care setting.

1. Did the training meet all of the stated learning objectives?*

1 - The learning objectives were not met 2 - The learning objectives were somewhat met 3 - The learning objectives were mostly met 4 - The learning objectives were completely met.

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2. The scholarship and expertise of Laszlo Madaras, MD, MPH, SFHM*

1 - Poor 2 - Slight 3 - Moderate 4 - Excellent

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3. Your overall satisfaction with this webinar training?*

1 - Dissatisfied 2 - Somewhat satisfied 3 - Mostly satisfied 4 - Completely satisfied

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4. The webinar presented new areas of knowledge, and/or new ideas/methods to implement.*

1 - Disagree 2 - Somewhat agree 3 - Mostly agree 4 - Completely agree

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5. The webinar contained information at a level commensurate with my training and experience.*

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6. How helpful was the information you learned today in enhancing your work within your health center or community?*

N/A - Not applicable 1 - Not helpful 2 - Somewhat helpful 3 - Mostly helpful 4 - Completely helpful

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7. If applicable, how do you plan to use the information you learned in your daily work activities?*

Please do not leave blank. Answer "N/A" if you have nothing to enter for this question.

8. Was the content balanced and free of commercial bias?*

1 - Yes 2 - No

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9. Did the speaker(s) fully disclose any conflict of interest and discussion of off-label usage of medications and/or medial devices?*

1 - Yes 2 - No

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10. Do you have any training, technical assistance, or resource needs? If so, please specify below.*

If you do not have any training or technical assistance needs please reply "None."

11. What is the biggest challenge you face when providing care or resources to your target population?*

If you are not facing any challenges please reply "None."

12. Additional Comments?*

If you do not have any additional comments, please reply "None."

13. Name (first and last)*

14. Please identify the type of organization you represent.*

1 - PCA (Primary Care Association) 2 - Health Center 3 - HCCN (Health Center Controlled Network) 4 - State/Federal Government Agency 5 - Other / Not included in this list 6 - I'm not sure / Don't know

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16. Address (Street Address or P.O. Box)*

17. City*

18. State*

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19. Zip Code*

20. Email Address*

21. Phone Number*

Please enter your phone number in one of the following formats: xxx - xxx - xxxx OR (xxx) xxx - xxxx

22. Please indicate the type of phone number you provided.*

1 - Cell/ Mobile 2 - Home 3 - Work/Office

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