HERO CE CONFERENCE EVALUATION
Please rate the overall Quality of the conference
*
Excellent
Very good
Good
Fair
Poor
Please rate the conference format
*
Excellent
Very good
Good
Fair
Poor
Please rate the quality of the lecture content/information
*
Excellent
Very good
Good
Fair
Poor
Please rate the quality of audio/visual component
*
Excellent
Very good
Good
Fair
Poor
Stated objectives were met
*
Strongly agree
Agree
Slightly agree
Disagree
Information/materials presented will alter or impact my facility performance
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Strongly agree
Agree
Slightly agree
Disagree
Information/materials presented reinforced to me that I’m doing the right things
*
Strongly agree
Agree
Slightly agree
Disagree
Information/materials presented are relevant to me/my facility
*
Strongly agree
Agree
Slightly agree
Disagree
Please rate how satisfied your expectations were met
*
Excellent
Very good
Good
Fair
Poor
How important are the SPEAKERS in your decision to attend a CE conference?
*
Very Important
Important
Neutral
Somewhat Important
Not Important
How important is the TARGET AUDIENCE in your decision to attend a CE conference?
*
Very Important
Important
Neutral
Somewhat Important
Not Important
How important is COST in your decision to attend a CE conference?
*
Very Important
Important
Neutral
Somewhat Important
Not Important
How important is the CONTENT in your decision to attend a CE conference?
*
Very Important
Important
Neutral
Somewhat Important
Not Important
How important is the LOCATION in your decision to attend a CE conference?
*
Very Important
Important
Neutral
Somewhat Important
Not Important
How important are the # of CE CREDITS/UNITS in your decision to attend a CE conference?
*
Very Important
Important
Neutral
Somewhat Important
Not Important
How important are conference DATES/TIMES in your decision to attend a CE conference?
*
Very Important
Important
Neutral
Somewhat Important
Not Important
Does your facility have a CLIA waiver?
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Yes
No
No, but I would like to
No, not interested at this time
How would you rate this conference for keeping the content bias free?
*
Excellent
Very Good
Good
Fair
Poor
Did you have adequate opportunity to receive answers to all of your questions?
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Yes
No
Have you attended a previous Continuing Education Conference?
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Yes
No
Do you practice in a rural or underserved area?
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Yes
No
Are you currently active with your LTC RISE partner?
*
Yes
No
Do you understand current regulations and guidance regarding proper use and documentation of psychotropic medications?
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Yes
No
Not applicable
Are you confident in your ability to prevent or if needed address commonly cited areas? (F-tags)
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Yes
No
Not applicable
Do you plan to implement an educational leadership program in your facility?
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Yes
No
Already have one in place
Not yet implemented, but would like to
Not implemented, not interested at this time
Suggestions for topics or improvements for the next CE conference.
*
Have you implemented the 4M's in your facility?
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Yes
No
Not yet implemented, but would like to
Not implemented and not interested at this time
Would your staff and facility benefit from utilizing Project FIRSTLine?
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Yes
No
Do you feel you need to enhance the trauma informed care program in your facility?
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Yes
No
Not yet implemented, but would like to
Not implemented and not interested at this time
Do you understand how to recognize the warning signs of suicide with the ability to reduce immediate risk and/or refer appropriately for long term care?
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Yes
No
Not applicable
Do you have Indoor Air Quality (IAQ) technologies in your facility?
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Yes
No
No, but would like to
No, not interested at this time
Would a CNA training course improve staffing at your facility?
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Yes
No
Maybe, I would like more information about this
Unsure, but not interested at this
Are you comfortable with interpreting and responding to dementia related behaviors?
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Yes
No
Not applicable
Do you currently offer hospice and palliative care education at your facility?
*
Yes
No
No, but would like to
Not, not interested at this time
Enter the Name and City of your facility
*
Enter your Name (First)
*
Enter your Name (Last)
*
Select your Credentials.
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NHA
PCHA
RN
LPN
DO
Other
How would you like to receive your CE certificate?
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Mail (provide mailing address)
Email (provide email address)
Both (provide both)
Enter EMAIL address
*
example@example.com
Enter MAILING address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Enter the total number of hours you attended at this conference. Attendees that attended all lectures Wednesday and Thursday can claim up to twelve (12) hours
*
How did you participate on Wednesday?
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Online
In person
How did you participate on Thursday?
*
Online
In person
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