Course Name:
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Course Date: |
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Faculty: |
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Candidate Name: |
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Mobile: |
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Specialty: |
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Country: |
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Hospital Address: |
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Telephone: |
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Email Address: |
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Please state your position in the hospital: |
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Please state the number of years you have been in practice: |
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Please state the number of cases you perform by yourself per year: |
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How would you grade this event: |
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The Health Economic session was relevant & informative (if applicable): |
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There was enough time to interact with colleagues: |
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The content was educational enough to help me to improve my practice: |
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The presentation was engaging and comprehensive: |
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Overall, I was satisfied with this event: |
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Faculty Speaker |
Teaching skills: |
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Ability to teach a reproducible technique: |
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Ability to discuss how to avoid complications & answer all questions: |
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Honest on his own experience: |
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Ability to build a clinical program: |
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Know–how to easily approach the participants: |
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Ready to answer all questions and enter into discussion and debate with participants: |
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Please grade the following. The products I was trained on meets my needs: |
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I find a place/procedure where I can apply the products in my practice: |
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How would you rate the demo session (if applicable): |
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What values do you see this course is adding to your practice: |
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Do you believe you require further information before trying these techniques: |
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What type of additional information would you need: |
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Hotel Accommodation (if applicable): |
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Group Dinner (if applicable): |
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SSI Staff: |
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What is ONE KEY LEARNING you have taken away from this event: |
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SSI would like to further contact you, in regard to new professional education possibilities that we can offer you:
If you wish to be in the database, please add you e-mail address/s: |
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