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* 1. Check appropriate title.

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* 2. Please rate your overall satisfaction with the organization of this meeting.

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* 3. The ACCME defines commercial bias as presentations giving an unbalanced view of therapeutic options by promoting a specific proprietary business interest of a commercial interest.

Was this CME course free of commercial bias?

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* 4. Did the faculty disclose significant relationships with commercial support?
(One or more of these methods: Syllabus / Opening Remarks / Verbally / On Slides)

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* 5. Please rate the quality of the meeting facilities.

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* 6. How well were the Calusa Spine course objectives met?

Upon completion of the course participants should be able to:

  Significantly Met Somewhat Met Not Met
Evaluate and discuss treatment options for ambulatory and outpatient spine conditions
Assess the current and future trends in emerging technologies
Assess the general health care marketplace

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* 7. Did you meet your personal goal/objective for what you intended to get out of this course?

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* 8. Do you intend to integrate what you learned at this conference into your current practice?

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* 9. Please rate the relevance of this program to your scope of practice:

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* 10. Please rate the OVERALL EFFECTIVENESS of each of our Calusa Spine Ambulatory Spine Conference speakers
SESSION I: Ambulatory Options for Lumbar Spondylosis

  Excellent Very Good Good Fair Poor
Reginald Davis, MD - Case Presentation
Donald Hales, MD - Evidence-Based Management of Spinal Stenosis
Donald Hales, MD - Interlaminar Decompression Stabilization 
Ryan DenHaese, MD - Spinous Process Stabilization vs MIS Pedicle Screw Fixation & Lateral Lumbar Fusion: Prospective Randomized Trial with 2-year Data
James Yue, MD - Full Endoscopic Lumbar Decompression
Larry Knoo, MD - Long-term Results of Minimally Invasive Tubular Decompression in 500 Patients: Outcomes, Complications, Limitations, and New Technologies
Michael Weiss, DO - Scholarly Expertise 

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* 11. Please rate the OVERALL EFFECTIVENESS of each of our Calusa Spine Ambulatory Spine Conference speakers
SESSION II: Ambulatory Options for Cervical Spondylosis

  Excellent Very Good Good Fair Poor
Reginald Davis, MD - Case Presentation 
Michael Weiss, DO - Cervical Decompression 
Reginald Davis, MD - Anterior Cervical Fusion 
James Yue, MD - Total Disc Replacement 
Michael Weiss, DO - Scholarly Expertise
Scott Becker - Keynote Speaker

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* 12. Please rate the OVERALL EFFECTIVENESS of each of our Calusa Spine Ambulatory Spine Conference speakers
SESSION III: The State of the Ambulatory Spine Industry

  Excellent Very Good Good Fair Poor
Jamie Adams - Who is in Dr. Google's Waiting Room?
Stephen H. Hochschuler, MD - The Role of Retrospective and Predictive Analytics in Bundled Payments
Jamie Adams - Scholarly Expertise

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* 13. Please rate the OVERALL EFFECTIVENESS of each of our Calusa Spine Ambulatory Spine Conference speakers
SESSION IV: Industry Innovations 

  Excellent Very Good Good Fair Poor
Robin Young, - Leading Technologies for 2017 
Joseph Zavatsky, MD - MMG for Lateral Interbody Fusion 
Joseph Zavatsky, MD - MMG for Posterior Decompression Surgery
Chip Wade, PhD - Vertebral Motion Analysis
Lisa Ferrara, PhD - New Areas of Technologies and Mechanotransduction for Metals vs PEEK
Larry Khoo, MD - Techniques to Optimize Sagittal Correction in Single Level Interbody Fusion and Long-Term Outcomes
Michael Weiss, DO - Scholarly Expertise 
Ret. Major General Barrye L. Price, PhD - Keynote Speaker

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* 14. Please rate the OVERALL EFFECTIVENESS of each of our Calusa Spine Ambulatory Spine Conference speakers
SESSION V: Advanced Ambulatory Treatment Options

  Excellent Very Good Good Fair Poor
John Peloza, MD - Oblique Lateral Interbody Fusion 
Robert Blok, Jr, DO - MIS Posterior Cervical Fusion 
John Kimball, MD - Toracic Lateral Extraforaminal Decompression 
Michael Weiss, DO - Scholarly Expertise

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* 15. Please rate the OVERALL EFFECTIVENESS of each of our Calusa Spine Ambulatory Spine Conference speakers
SESSION VI: Biomechanics

  Excellent Very Good Good Fair Poor
Reginald Davis, MD - Interspinous Process Fixation 
Lisa Ferrara, PhD - Interbody Biomechanics
Michael Weiss, DO - Scholarly Expertise 

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* 16. Please rate the OVERALL EFFECTIVENESS of each of our Calusa Spine Ambulatory Spine Conference speakers
SESSION VII: Biologics

  Excellent Very Good Good Fair Poor
Adam Bruggeman, MD - Surface Technology Clinical Outcomes
Boyle Cheng, PhD - The Science of Interbody Bone Growth
John Peloza, MD - Stem Cell Therapies
Douglas Beall, MD - Stem Cell Augmentation for the Intervertebral Disc
Larry Khoo, MD - The Use of Umbilical Cord Stem Cells in the Treatment of Sciatica and for Spinal Fusion
Timothy Ganey, PhD - Biopotential of Exosomes in Regenerative Medicine 
Kevin Foley, MD - Nucleus Pulposus Repair Utilizing Human Disc Progenitor Cells
Michael Weiss, DO - Scholarly Expertise
Michael Steele - Keynote Speaker

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* 17. Please rate the OVERALL EFFECTIVENESS of each of our Calusa Spine Ambulatory Spine Conference speakers
SESSION VIII: Potpurri

  Excellent Very Good Good Fair Poor
Lynette Bear, CRNA, DNP - Sleep Apnea and the Impact on ASCs
Nelson Hendler, MD - How to Increase Surgeons Revenue by Using Online Medical Assessment Tools from MCD
Michael Weiss, DO - Scholarly Expertise

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* 18. Please rate the OVERALL EFFECTIVENESS of each of our Calusa Spine Ambulatory Spine Conference speakers
SESSION IX: Health Care and Business Law

  Excellent Very Good Good Fair Poor
Jamie Adams - Marketing Business Models in Spine Surgery
Christopher Knopik - Legal Issues for ASCs Today
Adam Bruggeman, MD - Payer Landscpape
Michael Weiss, DO - Scholarly Expertise

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* 19. Based on your CME needs, please give suggestions for future program topics/formats.

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* 20. What barriers do you foresee that may hinder your implementation of changes learned at this activity? What educational strategies could help to overcome these barriers?

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* 21. What do you see as your BIGGEST challenge in improving patient safety, patient care and/or patient outcomes? What educational strategies could help to overcome this challenge?

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* 22. Please rate thefollowing:

  Excellent Very Good Good Fair Poor
Conference Location
Length of Conference
Recreational Activites

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* 23. What are your thoughts on extending the conference and beginning Friday afternoon?

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* 24. Would you be interested in attending this conference again next year?

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* 25. How did you hear about this CME Program?

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* 26. Please provide your contact information.

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* 27. This activity has been planned and implemented in accordance with ethe accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Foundation for Orthopaedic Research and Education (FORE) and The Spine Research Foundation. FORE is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement Foundation for Orthopaedic Research and Education designates this live activity for a maximum of 16 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Please attest below:

T