CNE Evaluation – Immunization Reminder and Recall Interventions Name * First Last Name * Last Credentials * Practice/Organization * Email Address * Phone Number * Address * Address 2 City * State * ------AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip * Which regional presentation did you attend? Columbus - 10/17/16 Cleveland - 11/2/16 Cincinnati - 11/9/16 OBJECTIVES: At the conclusion of this activity, are you able to: Define immunization reminders and recall * Yes No Present examples of immunization reminder and recall strategies * Yes No Discuss the benefits of and barriers to use of reminder/recall interventions for immunizations * Yes No SPEAKERS: On a scale of 1-5, with 1 being Strongly Disagree and 5 being Strongly Agree, please rate the following statements. Speaker demonstrated teaching effectiveness: Rebecca Brady, MD, FAAP * 1 2 3 4 5 Speaker demonstrated teaching effectiveness: Tamara Yates, RN * 1 2 3 4 5 Speaker demonstrated teaching effectiveness: Melanie Farkas * 1 2 3 4 5 OVERALL PRESENTATION: On a scale of 1-5, with 1 being Strongly Disagree and 5 being Strongly Agree, please rate the following statements. The presentation was well organized and logically sequenced. * 1 2 3 4 5 The material was not too difficult to understand. * 1 2 3 4 5 I gained new information. * 1 2 3 4 5 How would you rate your overall satisfaction with this activity? * Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied Additional Comments: By signing or typing your name, you confirm your identity and attest to attending the entire educational activity. * Clear If you are human, leave this field blank.
