Online Survey Software | Qualtrics Survey Solutions

Event Survey ONLINE MODULE:
Parkinson's Disease: A webinar for Healthcare Professionals
wycoa@uwyo.edu | 307-766-2829 | http://www.uwyo.edu/wycoa

PLEASE COMPLETE THE EVALUATION SURVEY BELOW

*this survey is required to be completed to receive your certificate of completion for CE reporting (Est 2 minute completion time)

Please take a few minutes to complete this survey. We request your information to help us secure continued funding. Event Survey information is crucial for our reports to the Federal Bureau of Health Professions, a major funding agency for geriatric - related education programs.

All information provided is kept strictly confidential.

We are required by our Federal funders to create an Anonymous ID Code to track your participation in future trainings. This information is confidential and will not be shared beyond WyCOA and our funder. However, it is important that we have complete information. You will use this unique code on all future training evaluations.

Year of Birth

1st letter of your LAST name

The last letter of LAST name

Gender

Please Provide:

First Name

Last Name

Have you completed this form in the past 6 months?

Yes
No