Mission

CME

Sponsorship

CME Needs Survey

Contact Information

Needs Assessment Survey

1. Personal information

First Name

Last name

E-mail address

Name of organization

Medical degree (M.D. or D.O.)

2. Area(s) of medical specialty: Please check each box that applies.

Area of surgical specialty

Other (optional)

3. How interested are you in taking category 1 CME courses on the Internet?

Very interested Maybe interested Not interested

4. What educational topics would you like to see in future online CME programs?

5. What is your learning style preference? Please check each box that applies?

Diadactic- lecture format
Live Event, if so, what type:
Enduring Material, if so, what type:
Internet
Hands-on practice
Other:

6. What computer system would you most likely use when taking CME courses?

PC
Mac
Either
Other:

7. Please list your favorite Internet health care sites. Include Internet address (URL) if available.

8. Additional comments: