Overall Activity Assessment: *

	Very Low	Low	Moderate	High	Very High
To what extent were you satisfied with the overall quality of the activity?	To what extent were you satisfied with the overall quality of the activity? - Very Low	To what extent were you satisfied with the overall quality of the activity? - Low	To what extent were you satisfied with the overall quality of the activity? - Moderate	To what extent were you satisfied with the overall quality of the activity? - High	To what extent were you satisfied with the overall quality of the activity? - Very High
To what extent was the content of the program relevant to your practice?	To what extent was the content of the program relevant to your practice? - Very Low	To what extent was the content of the program relevant to your practice? - Low	To what extent was the content of the program relevant to your practice? - Moderate	To what extent was the content of the program relevant to your practice? - High	To what extent was the content of the program relevant to your practice? - Very High
To what extent will you make a change in practice/professional responsibilities?	To what extent will you make a change in practice/professional responsibilities? - Very Low	To what extent will you make a change in practice/professional responsibilities? - Low	To what extent will you make a change in practice/professional responsibilities? - Moderate	To what extent will you make a change in practice/professional responsibilities? - High	To what extent will you make a change in practice/professional responsibilities? - Very High
As a result of participating in this activity, to what degree will you be able to describe the use and application of telehealth and telemedicine in caring for patients?	As a result of participating in this activity, to what degree will you be able to describe the use and application of telehealth and telemedicine in caring for patients? - Very Low	As a result of participating in this activity, to what degree will you be able to describe the use and application of telehealth and telemedicine in caring for patients? - Low	As a result of participating in this activity, to what degree will you be able to describe the use and application of telehealth and telemedicine in caring for patients? - Moderate	As a result of participating in this activity, to what degree will you be able to describe the use and application of telehealth and telemedicine in caring for patients? - High	As a result of participating in this activity, to what degree will you be able to describe the use and application of telehealth and telemedicine in caring for patients? - Very High
As a result of participating in this activity, to what degree will you be able to direct physicians and other clinicians to available resources to assist with the implementation of telehealth?	As a result of participating in this activity, to what degree will you be able to direct physicians and other clinicians to available resources to assist with the implementation of telehealth? - Very Low	As a result of participating in this activity, to what degree will you be able to direct physicians and other clinicians to available resources to assist with the implementation of telehealth? - Low	As a result of participating in this activity, to what degree will you be able to direct physicians and other clinicians to available resources to assist with the implementation of telehealth? - Moderate	As a result of participating in this activity, to what degree will you be able to direct physicians and other clinicians to available resources to assist with the implementation of telehealth? - High	As a result of participating in this activity, to what degree will you be able to direct physicians and other clinicians to available resources to assist with the implementation of telehealth? - Very High
As a result of participating in this activity, to what degree will you be able to inform of best practices for conducting a Medicare Annual Wellness Visit both for in person and synchronous audio video visits?	As a result of participating in this activity, to what degree will you be able to inform of best practices for conducting a Medicare Annual Wellness Visit both for in person and synchronous audio video visits? - Very Low	As a result of participating in this activity, to what degree will you be able to inform of best practices for conducting a Medicare Annual Wellness Visit both for in person and synchronous audio video visits? - Low	As a result of participating in this activity, to what degree will you be able to inform of best practices for conducting a Medicare Annual Wellness Visit both for in person and synchronous audio video visits? - Moderate	As a result of participating in this activity, to what degree will you be able to inform of best practices for conducting a Medicare Annual Wellness Visit both for in person and synchronous audio video visits? - High	As a result of participating in this activity, to what degree will you be able to inform of best practices for conducting a Medicare Annual Wellness Visit both for in person and synchronous audio video visits? - Very High
As a result of participating in this activity, to what degree will you be able to direct physicians to available resources and best practices for conducting functional, safety and cognitive assessments and depressions screenings?	As a result of participating in this activity, to what degree will you be able to direct physicians to available resources and best practices for conducting functional, safety and cognitive assessments and depressions screenings? - Very Low	As a result of participating in this activity, to what degree will you be able to direct physicians to available resources and best practices for conducting functional, safety and cognitive assessments and depressions screenings? - Low	As a result of participating in this activity, to what degree will you be able to direct physicians to available resources and best practices for conducting functional, safety and cognitive assessments and depressions screenings? - Moderate	As a result of participating in this activity, to what degree will you be able to direct physicians to available resources and best practices for conducting functional, safety and cognitive assessments and depressions screenings? - High	As a result of participating in this activity, to what degree will you be able to direct physicians to available resources and best practices for conducting functional, safety and cognitive assessments and depressions screenings? - Very High

Did this activity present scientifically rigorous, unbiased, and balanced information? *

Yes

No, please describe:

Did this activity present scientifically rigorous, unbiased, and balanced information? No, please describe:

List 2 or more changes you will implement into your practice as a result of participation in this activity: *

Leave this field blank