I have been a practicing clinician for: * - Select -Less than 1 year1-5 years 6-10 years 11-15 years16-20 years20+ years I do not currently practice Please indicate which of the following best describes your specialty: * - Select -Endocrinology, MetabolismCardiology, GeneralFamily/Internal Medicine/Primary Care HospitalistNeurologyGastroenterology ImmunologyNephrologyGenetics and Genomics DermatologyPsychiatrySurgeryPhDFunctional/Integrative PharmacistI do not currently practice Please select the extent to which you agree/disagree that the activity supported the achievement of each learning objectives? * Strongly DisagreeDisagreeNeutralAgreeStrongly Agree Review the epidemiology and case definition of CIRS Review the epidemiology and case definition of CIRS - Strongly Disagree Review the epidemiology and case definition of CIRS - Disagree Review the epidemiology and case definition of CIRS - Neutral Review the epidemiology and case definition of CIRS - Agree Review the epidemiology and case definition of CIRS - Strongly Agree Perform a comprehensive evaluation of the CIRS patient Perform a comprehensive evaluation of the CIRS patient - Strongly Disagree Perform a comprehensive evaluation of the CIRS patient - Disagree Perform a comprehensive evaluation of the CIRS patient - Neutral Perform a comprehensive evaluation of the CIRS patient - Agree Perform a comprehensive evaluation of the CIRS patient - Strongly Agree Synthesize and apply validated treatments for the CIRS patient, including those affected by mold and lyme disease Synthesize and apply validated treatments for the CIRS patient, including those affected by mold and lyme disease - Strongly Disagree Synthesize and apply validated treatments for the CIRS patient, including those affected by mold and lyme disease - Disagree Synthesize and apply validated treatments for the CIRS patient, including those affected by mold and lyme disease - Neutral Synthesize and apply validated treatments for the CIRS patient, including those affected by mold and lyme disease - Agree Synthesize and apply validated treatments for the CIRS patient, including those affected by mold and lyme disease - Strongly Agree If you answered "Strongly Disagree" or "Disagree" please explain: Please select the extent to which you agree/disagree that the activity achieved the following: * Strongly DisagreeDisagreeNeutralAgreeStrongly Agree The content was evidence-based The content was evidence-based - Strongly Disagree The content was evidence-based - Disagree The content was evidence-based - Neutral The content was evidence-based - Agree The content was evidence-based - Strongly Agree The educational material provided useful information for my practice The educational material provided useful information for my practice - Strongly Disagree The educational material provided useful information for my practice - Disagree The educational material provided useful information for my practice - Neutral The educational material provided useful information for my practice - Agree The educational material provided useful information for my practice - Strongly Agree The opportunities provided to assess my own learning were appropriate (e.g., questions before, during or after the activity) The opportunities provided to assess my own learning were appropriate (e.g., questions before, during or after the activity) - Strongly Disagree The opportunities provided to assess my own learning were appropriate (e.g., questions before, during or after the activity) - Disagree The opportunities provided to assess my own learning were appropriate (e.g., questions before, during or after the activity) - Neutral The opportunities provided to assess my own learning were appropriate (e.g., questions before, during or after the activity) - Agree The opportunities provided to assess my own learning were appropriate (e.g., questions before, during or after the activity) - Strongly Agree If you answered "Strongly Disagree" or "Disagree" please explain: To what degree did/will this activity: * SignificantlyModeratelyMinimallyNot at all Increase your knowledge Increase your knowledge - Significantly Increase your knowledge - Moderately Increase your knowledge - Minimally Increase your knowledge - Not at all Change your competence Change your competence - Significantly Change your competence - Moderately Change your competence - Minimally Change your competence - Not at all Change your practice performance Change your practice performance - Significantly Change your practice performance - Moderately Change your practice performance - Minimally Change your practice performance - Not at all Change patient care Change patient care - Significantly Change patient care - Moderately Change patient care - Minimally Change patient care - Not at all Do you plan to implement & utilize the information you have received at this course? * Yes No If you answered "No", please explain: Which of the following do you anticipate will be the primary barrier to implementing these changes? * Time constraints System constraints Insurance/financial issues Lack of inter-professional team support Treatment related adverse events Lack of convincing evidence to warrant change Lack of knowledge regarding evidence-based strategies Patient adherence/compliance I do not currently practice Other... Which of the following do you anticipate will be the primary barrier to implementing these changes? Other... Was this activity free of commercial bias? * Yes No If you answered "No", please explain: Please rate the faculty * Excellent Above Average Average Fair Poor Andrew Heyman, MD MHSA Andrew Heyman, MD MHSA - Excellent Andrew Heyman, MD MHSA - Above Average Andrew Heyman, MD MHSA - Average Andrew Heyman, MD MHSA - Fair Andrew Heyman, MD MHSA - Poor Ritchie Shoemaker, MD Ritchie Shoemaker, MD - Excellent Ritchie Shoemaker, MD - Above Average Ritchie Shoemaker, MD - Average Ritchie Shoemaker, MD - Fair Ritchie Shoemaker, MD - Poor Please feel free to comment on any aspect of this activity. (Optional) Specific to your specialty, what other topics would be beneficial in your practice for future educational activities? Women's HealthMen’s HealthChronic Inflammatory Response SyndromeGenomicsToxinsHRTWeight ManagementNutritionSports MedicineImmunity and AgingPeptidesOther... Specific to your specialty, what other topics would be beneficial in your practice for future educational activities? Other... I prefer to receive CME through: * - Select -Live EventsOnline CMEMedical Journals or NewslettersOther... I prefer to receive CME through: Other... Leave this field blank
