Exit DHPD - Improving the Oral Health of Pregnant Women, Children & Families Evaluation Question Title * 1. Today's Date: Date Date Question Title * 2. Which type(s) of certificate would you like? CHW/CHR Certificate (5.75 Units from the New Mexico Department of Health) Continuing Medical Education Certificate for Physicians (6.25 Units) Continuing Medical Education Certificate for Non-Physicians (6.25 Units) Not Applicable (not requesting CEUs or CMEs) Question Title * 3. Please provide your name and email address if you are requesting CEUs or CMEs. Name Email Address Question Title * 4. What is your role? Community Health Worker (CHW) Community Health Representative (CHR) Other (please specify) Question Title * 5. Which county do you serve? (If multiple, choose primary county) Bernalillo Catron Chaves Cibola Colfax Curry De Baca Dona Ana Eddy Grant Guadalupe Harding Hidalgo Lea Lincoln Los Alamos Luna McKinley Mora Otero Quay Rio Arriba Roosevelt Sandoval San Juan San Miguel Santa Fe Sierra Socorro Taos Torrance Union Valencia Question Title * 6. Training Objectives and Content Strongly Agree Agree Disagree Strongly Disagree The objectives of this session were clearly explained The objectives of this session were clearly explained Strongly Agree The objectives of this session were clearly explained Agree The objectives of this session were clearly explained Disagree The objectives of this session were clearly explained Strongly Disagree Overall the session met its objectives Overall the session met its objectives Strongly Agree Overall the session met its objectives Agree Overall the session met its objectives Disagree Overall the session met its objectives Strongly Disagree Question Title * 7. Because I attended this training: Strongly Agree Agree Disagree Strongly Disagree I have gained valuable knowledge and skills I have gained valuable knowledge and skills Strongly Agree I have gained valuable knowledge and skills Agree I have gained valuable knowledge and skills Disagree I have gained valuable knowledge and skills Strongly Disagree There will be a positive impact on my professional work There will be a positive impact on my professional work Strongly Agree There will be a positive impact on my professional work Agree There will be a positive impact on my professional work Disagree There will be a positive impact on my professional work Strongly Disagree Question Title * 8. Overall, I am satisfied with the training. Strongly Agree Agree Disagree Strongly Disagree Strongly Agree Agree Disagree Strongly Disagree Question Title * 9. Do you feel this presentation conveyed any commercial bias? No Yes Question Title * 10. Can you think of changes you might make to your professional practice as a result of this training? Question Title * 11. What do you think some of the barriers will be to making changes in your practice? Next
