To receive continuing education credit, completion of this Evaluation is mandatory. Last Name ____________________________________________ First Name _ ___________________________________ MI _______ State ____________________________ License # _______________________________________ Expiration Date _ ______________ Evaluation (Completion of this form 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? Elite Learning
DHFL2626
Caries-Prone Patients: Prevention, Assessment, and Interventions,
The Impact of Vascular and Cardiovascular Diseases on Oral Health, 4th Edition 4 CE Hours
Domestic Violence: The Florida
Medical Error Prevention and Root Cause Analysis (Mandatory) 2 CE Hours
Oral Cancer and Complications of Cancer Therapies 5 CE Hours
Requirement (Mandatory) 2 CE Hours
Managing Disruptive Patients 9 CE Hours
3rd Edition 4 CE Hours
1. New
1. New
1. New
1. New
1. New
1. New
Review 2. _____ Hours
Review 2. _____ Hours
Review 2. _____ Hours
Review 2. _____ Hours
Review 2. _____ Hours
Review 2. _____ Hours
3. Yes No 4. Yes No 5. Yes No 6. Yes No 7. Yes No 8. Yes No 9. Yes No 10. Yes No 11. Yes No 12. Yes No
3. Yes No 4. Yes No 5. Yes No 6. Yes No 7. Yes No 8. Yes No 9. Yes No 10. Yes No 11. Yes No 12. Yes No
3. Yes No 4. Yes No 5. Yes No 6. Yes No 7. Yes No 8. Yes No 9. Yes No 10. N/A 11. Yes No 12. Yes No
3. Yes No 4. Yes No 5. Yes No 6. Yes No 7. Yes No 8. Yes No 9. Yes No 10. Yes No 11. Yes No 12. Yes No
3. Yes No 4. Yes No 5. Yes No 6. Yes No 7. Yes No 8. Yes No 9. Yes No 10. N/A 11. Yes No 12. Yes No
3. Yes No 4. Yes No 5. Yes No 6. Yes No 7. Yes No 8. Yes No 9. Yes No 10. N/A 11. Yes No 12. Yes No
If you answered YES to question #12 for any of the courses in this book, how specifically will this activity enhance your role as a member of the interdisciplinary team? Domestic Violence: The Florida Requirement (Mandatory) ____________________________________________________________ ____________________________________________________________________________________________________________ Medical Error Prevention and Root Cause Analysis (Mandatory) ________________________________________________________ ____________________________________________________________________________________________________________ Caries-Prone Patients: Prevention, Assessment, and Interventions, 3rd Edition ____________________________________________ ____________________________________________________________________________________________________________ Managing Disruptive Patients ____________________________________________________________________________________ ____________________________________________________________________________________________________________ Oral Cancer and Complications of Cancer Therapies _________________________________________________________________ ____________________________________________________________________________________________________________ The Impact of Vascular and Cardiovascular Diseases on Oral Health, 4th Edition __________________________________________ ____________________________________________________________________________________________________________
Signature ______________________________________________________________________________________________ Signature required to receive continuing education credit.
109
EliteLearning.com/Dental
Powered by FlippingBook