Pediatric Weight Management Evaluation (CME) Form

CTC-RI CME Sessions Eval & Credit Request

Thank You!

Thank you for participating in the Pediatric Weight Management ECHO. To be sure we are meeting your needs, we would like your feedback on the session you just attended.

Please complete the evaluation even if you are not requesting CME credit as it gives us a chance to evaluate the work that we are doing and its overall impact.

If you would like CME credit, you will be directed to a second page to input your information. You can expect to receive a certificate approximately 30 days after submission.

Question Title

* 1. Tell Us About You

Name

Email Address

Question Title

* 2. Designation

BH Provider

Other (please specify)

Pediatric Weight Management Evaluation (CME) Form

CTC-RI CME Sessions Eval & Credit Request

Question Title

* 1. Tell Us About You

Question Title

* 2. Designation

Question Title

* 3. What date & meeting are you filling this evaluation out for?