• 2026 USPHS Symposium Evaluation and CE Form

  • Date
     - -
    2 digit month, 2 digit day, 4 digit year

  • Fill out this form if you are:

    - applying for CHES/MCHES Credits

    - applying for Engineer/Environmental Health PDH

    - applying for Therapist CE Credits

    - applying for Veterinary CE Credits

    - applying for General Credits

                 -OR-

    - are NOT applying for CE, but wish to evaluate the symposium.

    ALL OTHERS VISIT THE WEBSITE AND CHECK YOUR CATEGORY FOR THE CORRECT FORM.

  • Are you applying for continuing education credits?*
  • Please select your assigned Agency/OPDIV detail.*

  • Please enter your DISCIPLINE*

  • Fill out the below form for each session you attend.

  • Please answer the following questions thinking about the overall conference:

  • A. Please rate your level of agreement by selecting the appropriate rating.

    After participating in this activity, I am now better able to:

  • Discuss the Surgeon General’s and Chief Professional Officer’s identified priority areas*
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  • Identify three actions the attendee can implement in day-to-day work to improve competency in addressing priority areas*
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  • Cite three best practices for improving public health in the priority areas*
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  • Explain how the identified priorities would apply during deployment*
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  • B. Please rate your level of agreement by selecting the appropriate rating:

  • The faculty were effective in presenting the material*
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  • Information in this activity is relevant to my clinical practice or job role.*
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  • The activity increased my knowledge on this topic.*
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  • The activity provided appropriate and effective opportunities for active learning (e.g., case studies, discussion, Q&A, etc.)*
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  • The opportunities provided to assess my own learning were appropriate (e.g., questions before, during or after the activity)*
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  • Information presented in this activity will help me improve patient outcomes or effectiveness in my job role.*
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  • C. Please rate your level of agreement by selecting the appropriate rating:

    The content presented:

  • Was scientifically rigorous and evidence based.*
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  • Was fair, balanced, objective, and free of commercial bias.*
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  • D.  Please select the appropriate answer for your experience:

  • Based upon your participation in this activity, do you intend to change your practice behavior? (choose only one of the following options)*
  • If you plan to change your practice behavior, what type of changes do you plan to implement? (check all that apply)*

  • How confident are you that you will be able to make your intended changes?*
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  • Which of the following do you anticipate will be the primary barrier to implementing these changes?*

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