Course Evaluation and Attendance Form: 2022 HOAECC

Please complete the following survey for each session attended in order to receive COPE approved continuing education credit.



COPE Number:

Based on information provided in the session today,

A. Please provide a brief summary of what you learned.

B. List one thing learned in this session that you can implement into patient care when you return home.

C. What is one way you can keep yourself accountable to implementing change learned from this session.

D. As a result of this CE, I expect significant changes in my patient outcomes.

(1 = Strongly Disagree, 10 = Strongly Agree)

E. This session enhanced my learning experience by being live and in-person.

(1 = Strongly Disagree, 10 = Strongly Agree)

F. Please provide one detail that might improve the manner in which this session was administered.


Signature Date: