PACCM Grand Rounds Check In

PACCM Grand Rounds Check In

Date*

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?

Select or enter value

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)

Send me a copy of my responses

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