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CDIP-CME Enduring MTM Eval (MDs)

CME Evaluation Form

Medication Therapy Management: Opportunities in an Underutilized Services

1. What is your full name as it should appear on the certificate? *This question is required.

2. I confirm that I am a physician and I viewed the archived webinar below in its entirety:
(For RNs and Others please go back to the main webpage and click on "Other Health Care Providers" to obtain a Certificate of Attendance) *This question is required.

3. On which date did you view the webinar?
*This question is required. Use this format - MM/DD/YYYY or click on the dropdown calendar.
This question requires a valid date format of MM/DD/YYYY.

calendar

5. Email address: *This question is required. This question requires a valid email address.

6. Overall, how well were the objectives met?

*This question is required.

Space Cell	Fully Met	Somewhat Met	Not Met
•Identify the need for medication therapy management (MTM)
•Describe how MTM benefits patients and providers
•Explain the scope, process and components of MTM
•Explain how to collaborate with MTM providers
•Evaluate how current opportunities coincide with your practice as a primary care provider.

7. How likely are you to change your practice based on today’s activity? *This question is required.

8. If you answered very likely or somewhat likely, please describe how you intend to change your practice based on the content of this activity

9. Presenters- Optional:
Please check the box that indicates the effectiveness of each presenter:

Space Cell	Strongly Agree	Agree	Disagree	Strongly Disagree
Corey Edwards

10. Was there any apparent commercial bias in the presentation?
(Defined as content that promotes the proprietary interest of any specific entity that, produces, markets, re-sells, or distributes health care goods or services consumed by, or used on, patients.) *This question is required.

11. If you answered yes, there was commercial bias, please explain:

12. To assist us in planning future programs, please indicate topics you would like to have covered.

13. Do you have any other comments or suggestions?

14.

Are you a member of the Los Angeles Health Alert Network (LAHAN), the Department of Public Health’s (DPH) provider alert system? (optional)

15. Would you like us to sign you up for LAHAN?

Note: DPH uses LAHAN to email priority communications on issues such as local outbreaks, emerging health issues, and drug shortages. There are, on average, 1-2 communications a month and the urgency and target audience are clearly marked. DPH will not share your contact information and it is simple to unsubscribe. To learn more, ask questions, or view previous communications visit publichealth.lacounty.gov/lahan

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