Evaluation (Completion of this form is mandatory)
Elite Learning
SWTX3026
Last Name ____________________________________________ First Name _ ___________________________________ MI _ _____ State ____________________________ License # _______________________________________ Expiration Date _ _____________
To receive continuing education credit, completion of this Evaluation is mandatory.
Please read the following questions and choose the most appropriate answer for each course completed. 1. Was the course content new or review? 2. How much time did you spend on this activity, including the test questions? 3. Would you recommend this course to your peers? 4. Did the course content support the stated course objective? 5. Did the course content demonstrate the author’s knowledge of the subject? 6. Was the course content free of bias? 7. Before completing this course, did you identify the necessity for education on the topic to improve your professional practice? 8. Have you achieved all of the stated learning objectives of this course? 9. Has what you think or feel about this topic changed? 10. Did evidence-based practice recommendations assist in determining the validity or relevance of the information? 11. Are you more confident in your ability to provide patient care after completing this course? 12. Do you plan to make changes in your practice as a result of this course content?
Intercultural Competence and Patient-Centered Care (Mandatory) 4 CE Credit Hrs
Psychedelic Medicine and Interventional Psychiatry 10 CE Credit Hrs
Setting Ethical Limits: For Caring and Competent
Alcohol and Alcohol Use Disorders 10 CE Credit Hrs
Professionals (Mandatory) 6 CE Credit Hrs
1. New
1. New
1. New
1. New
Review 2. _____ Hours 3. Yes
Review 2. _____ Hours 3. Yes
Review 2. _____ Hours 3. Yes
Review 2. _____ Hours 3. Yes
No No No No No No No No No No
No No No No No No No No No
No No No No No No No No No
No No No No No No No No No No
4. Yes 5. Yes 6. Yes 7. Yes 8. Yes 9. Yes 10. Yes 11. Yes 12. Yes
4. Yes 5. Yes 6. Yes 7. Yes 8. Yes 9. Yes
4. Yes 5. Yes 6. Yes 7. Yes 8. Yes 9. Yes
4. Yes 5. Yes 6. Yes 7. Yes 8. Yes 9. Yes 10. Yes 11. Yes 12. Yes
10. N/A 11. Yes 12. Yes
10. N/A 11. Yes 12. Yes
Intercultural Competence and Patient-Centered Care — If you answered YES to question #12, how specifically will this activity enhance your
role as a member of the interdisciplinary team? ___________________________________________________________________________
Setting Ethical Limits: For Caring and Competent Professionals — If you answered YES to question #12, how specifically will this activity enhance
your role as a member of the interdisciplinary team? _______________________________________________________________________
Alcohol and Alcohol Use Disorders — If you answered YES to question #12, how specifically will this activity enhance your role as a member of
the interdisciplinary team? ___________________________________________________________________________________________
Psychedelic Medicine and Interventional Psychiatry — If you answered YES to question #12, how specifically will this activity enhance your role
as a member of the interdisciplinary team? _ _____________________________________________________________________________
Signature _________________________________________________________________________________ Signature required to receive continuing education credit.
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