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CME Evaluation Form:


Please complete this form for EACH CME Training Topic you review on-line.
Please print out a copy to submit with your Quiz Results Summary page print out. 

Key:
SA = Strongly Agree   A = Agree   U = Undecided   D = Disagree   SD = Strongly Disagree




On-Line Training Topic: ______________________________________________________________.




I am a (Circle one):
EMT-Basic   EMT-Intermediate   EMT-Paramedic   RN   MD/DO   Other   N/A




I am a Student (Cirlce one):
EMT-Basic   EMT-Intermediate   EMT-Paramedic   RN   MD/DO   Other   N/A




1)  This on-line topic met the educational objectives:
          SA . . . A . . . U . . . D . . . SD




2)  This on-line topic was beneficial to me:
          SA . . . A . . . U . . . D . . . SD




3)  This on-line topic was too advanced for me:
          SA . . . A . . . U . . . D . . . SD




4)  I found this teaching method to be effective:
          SA . . . A . . . U . . . D . . . SD




5)  I found this teaching method preferable to classroom presentations:
          SA . . . A . . . U . . . D . . . SD




6)  I will take other on-line CME offered by DocJC in the future:
          SA . . . A . . . U . . . D . . . SD
EMS On-Line CME DocJC's Home Page 
Version 1.0a    Jan 05
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