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Indian Country HCV ECHO Clinic

Cardea Services

Questions about this evaluation? Email info@cardeaservices.org.

We hope you found this educational offering both interesting and informative. Your anonymous responses will be used to plan future educational activities.

1. Please enter your unique identifying number using your birth month (mm), last two numbers of your cell phone number (##), and the first letter of your middle name (x). This number will be used to link your survey responses to future surveys you take while keeping your responses anonymous.

Example: 0989S
Birth Month: September (09)
Phone Number: 012-345-6789
Middle Name: Smith

3. How satisfied are you with this learning activity?

Very satisfied	Satisfied	Unsatisfied	Very unsatisfied
Very satisfied	Satisfied	Unsatisfied	Very unsatisfied

4.  As a result of this learning activity, how has your knowledge on this topic changed? *This question is required.

Improved a lot	Improved a little	Stayed the same	Got worse
Improved a lot	Improved a little	Stayed the same	Got worse

5. As a result of this learning activity, *This question is required.

Space Cell	Strongly agree	Agree	Disagree	Strongly disagree
I can provide better care for my patients who are experiencing grief.	I can provide better care for my patients who are experiencing grief.: Strongly agree	I can provide better care for my patients who are experiencing grief.: Agree	I can provide better care for my patients who are experiencing grief.: Disagree	I can provide better care for my patients who are experiencing grief.: Strongly disagree

6. How likely are you to make one change in practice based on what you learned in this activity? *This question is required.

Very likely	Likely	Unlikely	Very unlikely
Very likely	Likely	Unlikely	Very unlikely

Please describe any changes you plan to make in the work that you do. *This question is required.

Why are you unlikely to make a change? *This question is required.

Please enter an 'other' value for this selection.