Evaluation Form: Maximizing Patient Outcomes Through IV Iron Therapy and Appropriate Iron Measures

Medical Education Resources, Inc.

Maximizing Patient Outcomes Through IV Iron Therapy
and Appropriate Iron Measures
CME Internet Program

Thank you for participating in this CME Internet program. To earn CME credit, please print and complete this Evaluation Form along with the Posttest and return to Medical Education Resources, Inc. via fax at 303-798-5731 or mail:

Medical Education Resources, Inc
1500 West Canal Court, Suite 500,
Littleton, Colorado 80120-5617

Posttest ANSWER SHEET
Mark the answer that is correct for each Posttest question below: First click on the
Posttest Questions link
and print out the questions for your reference.
Release date: May, 2005 Valid through: May 15, 2006

For CME purposes, please complete the information requested below.

I, _________________________________________________do hereby certify that I spent ________ hours participating in this activity.

Please indicate your academic degree:

PhD

Other (Please specify ________________________________________________)*
*This program has not been accredited for nurses.

NAME (PLEASE PRINT)
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INSTITUTIONAL AFFILIATION
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Overall Program Evaluation

Please assess the following aspects of the program by circling the appropriate rating.
( 1. Excellent, 2. Very Good, 3. Good, 4. Fair, 5. Poor )

The program’s objectives were met.	1 2 3 4 5
The content was useful and relevant.	1 2 3 4 5
The material was presented at an acceptable level of expertise.	1 2 3 4 5
There was an opportunity to provide feedback.	1 2 3 4 5

Was the program educationally unbiased and nonpromotional?      Yes       No
If no, please explain.
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Will the program affect the way you practice?     Yes       No
If Yes , please explain.
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How would you improve this program?
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Would you like to learn more about this topic?    Yes       No

What other educational topics are of most interest to you?
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Presentation Evaluation
Please assess the following aspects of the presentations
by circling the appropriate rating.

Independent Benefits of IV Iron: Beyond Raising Hgb Levels
Rajiv Agarwal, MD

Content/Relevance	1 2 3 4 5
Presenter’s expertise in the topic	1 2 3 4 5
Effectiveness	1 2 3 4 5

Considerations in Iron Measures: What Is an Appropriate Serum Ferritin Level?
Daniel Coyne, MD

Content/Relevance	1 2 3 4 5
Presenter’s expertise in the topic	1 2 3 4 5
Effectiveness	1 2 3 4 5

Sponsored by Medical Education Resources, Inc.
Supported by an unrestricted educational grant from Watson Pharma, Inc.