Continuing Ed Survey Template

After you fill out this evaluation, you will receive a certificate with 0.5 contact hours listed.
You must include your work email address and name and complete the entire survey and click Submit in order to receive your contact hours.

Please allow 2 weeks. Only CSM associates may receive contact hours.
Name: 


A red asterisk (*) indicates required questions.

  1. Can you, as the participant of this online learning, INSERT FIRST OBJECTIVE HERE*
    Yes
    No


  1. Can you, as the participant of this online learning, INSERT SECOND OBJECTIVE HERE*
    Yes
    No


  1. Can you, as the participant of this online learning, INSERT THIRD OBJECTIVE HERE*
    Yes
    No


  1. Can you, as the participant of this online learning, INSERT FOURTH OBJECTIVE HERE*
    Yes
    No


  1. Can you, as the participant of this online learning, INSERT FIFTH OBJECTIVE HERE?*
    Yes
    No


  1. When the planning committee prepares courses for continuing education, they must disclose any conflicts of interest. Did they inform you of whether or not there were any such conflicts of interest at the beginning of the online learning?*
    Yes
    No


  1. Were the teaching methods appropriate to your learning?*
    Yes
    No


  1. Please enter your entire work e-mail address to receive your emailed certificate.





Matt Byrnes