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What type of credit are you claiming?*	You must fill out this field.
Presentation(s) were balanced and evidence based.*	Strongly agree Agree Disagree Strongly Disagree You must fill out this field.
Overall, my learning needs were met.*	Strongly agree Agree Disagree Strongly Disagree You must fill out this field.
Please enter comments if you selected disagree or strongly disagree for either question above:	You must fill out this field.
Did you identify any commercial/promotional influence that impacted the independence of the content?*	Yes No You must fill out this field.
Please describe any commercial or promotional influence that you observed:	You must fill out this field.
Will the knowledge you have gained compel you to make changes in your work?*	Yes No You must fill out this field.
Please describe the change(s) you plan to make and the expected time frame for implementation:	You must fill out this field.
Who else on your care team would you engage to make these changes? (check all that apply)	You must fill out this field.
Advanced Practice Provider (APRN, PA, NP, CNM, CRNA, CNS)	You must fill out this field.
Nurse	You must fill out this field.
Pharmacist	You must fill out this field.
Physician (MD, DO, DDS)	You must fill out this field.
Researcher	You must fill out this field.
Social Worker	You must fill out this field.
Other	You must fill out this field.
If you chose Other, please specify:	You must fill out this field.
Is there anything else you need in order to implement this change? (select all that apply)	You must fill out this field.
No, I can make this change myself	You must fill out this field.
More information or training	You must fill out this field.
Collaboration with and engagement of colleagues/others	You must fill out this field.
Institutional or systemic changes	You must fill out this field.
Other	You must fill out this field.
If you chose Other, please specify:	You must fill out this field.
Please indicate why you will not make any changes (skip if you are making a change):	You must fill out this field.
If you chose Unable to change, please specify why:	You must fill out this field.
Please list other topics you would like covered in future programs:	You must fill out this field.
Please share suggestions to improve your engagement in this learning activity:	You must fill out this field.

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