Feedback Form | IAOM 2023 Session 09 | Integration of Cranial Nerves to Improve Treatment Outcomes "*" indicates required fields 1Learning Objectives2Instructor and Content Ratings3Testimony/Review4Recommendations/Feedback5Certificate6 HiddenDate* MM slash DD slash YYYY Session Passcode (Case-sensitive):* The content of this course was consistent with the following stated learning objectives: Identify Cranial Nerve Function* Strongly Disagree Disagree Neutral Agree Strongly Agree Identify Cranial Nerve Dysfunction* Strongly Disagree Disagree Neutral Agree Strongly Agree Activate Cranial Nerve Sensory components* Strongly Disagree Disagree Neutral Agree Strongly Agree Activate Cranial Nerve Motor Components* Strongly Disagree Disagree Neutral Agree Strongly Agree Identify When to refer out* Strongly Disagree Disagree Neutral Agree Strongly Agree We are sorry this course did not meet your expectations but we value your feedback! Please let us know how we can improve in this area. Please rate the following aspects of the course instructor, contents, and delivery: The style of presentation was conducive to learning.* Strongly Disagree Disagree Neutral Agree Strongly Agree The instructor demonstrated a thorough knowledge of the subject matter.* Strongly Disagree Disagree Neutral Agree Strongly Agree Materials provided and speaker interactions were effective in facilitating learning.* Strongly Disagree Disagree Neutral Agree Strongly Agree Rate your ability BEFORE the course to utilize the knowledge/skills presented in the course.* Very Weak Weak Neutral Strong Very Strong Rate your ability AFTER the course to utilize the knowledge/skills presented in the course.* Very Weak Weak Neutral Strong Very Strong We are sorry this course did not meet your expectations but we value your feedback! Please let us know how we can improve in this area. Please provide your honest review of this course for others: What did you appreciate/enjoy about and/or learn from the course? What would your “testimony” be to others who are considering this course?* Would you give your permission for IAOM and/or this session's presenter, to use your feedback, with your name, in future promotional materials?* Yes, first and last name Yes, but first name only No We truly value your feedback. Please let us know how we can improve! What suggestions would you offer for improving this program? How will you utilize the knowledge and skills gained from this course to improve your practice? CEU and/or Certificate choices: I attest:* I have completed all course requirements to earn the prescribed CEUs and/or Certificate of Completion according to the standards of my professional organization. Please enter your full name. (must match your name from registration)* First Last Please enter your email address (must match your email from registration)* In which profession(s) do you hold licensure?* Speech-Language Pathologist Dental Hygienist Dentist Occupational Therapist Physical Therapist SLP Assistant OT Assistant Dietician/Nutritionist Nurse Teacher Other Please list your other profession(s) separated by commas:* SLP Certificate and CEU Options* Generate my certificate and submit my completion to ASHA for CEUs. Note that by requesting ASHA CEUs you give consent to have your personally identifying information shared with ASHA for the purpose of awarding ASHA CEUS. Generate my certificate only. I do not desire ASHA CEUs. AGD Course Attendance Verification Form* Generate my AGD Course Attendance Verification Form. Certificate of Completion* Generate my Certificate of Completion HiddenCourse Title Line One HiddenCourse Title Line Two HiddenPresenter HiddenLength HiddenCompletion Date MM slash DD slash YYYY HiddenAGD Subject Code HiddenAGD Verification Code "*" indicates required fields 1Learning Objectives2Instructor and Content Ratings3Testimony/Review4Recommendations/Feedback5Certificate6 HiddenDate* MM slash DD slash YYYY Session Passcode (Case-sensitive):* The content of this course was consistent with the following stated learning objectives: Identify Cranial Nerve Function* Strongly Disagree Disagree Neutral Agree Strongly Agree Identify Cranial Nerve Dysfunction* Strongly Disagree Disagree Neutral Agree Strongly Agree Activate Cranial Nerve Sensory components* Strongly Disagree Disagree Neutral Agree Strongly Agree Activate Cranial Nerve Motor Components* Strongly Disagree Disagree Neutral Agree Strongly Agree Identify When to refer out* Strongly Disagree Disagree Neutral Agree Strongly Agree We are sorry this course did not meet your expectations but we value your feedback! Please let us know how we can improve in this area. Please rate the following aspects of the course instructor, contents, and delivery: The style of presentation was conducive to learning.* Strongly Disagree Disagree Neutral Agree Strongly Agree The instructor demonstrated a thorough knowledge of the subject matter.* Strongly Disagree Disagree Neutral Agree Strongly Agree Materials provided and speaker interactions were effective in facilitating learning.* Strongly Disagree Disagree Neutral Agree Strongly Agree Rate your ability BEFORE the course to utilize the knowledge/skills presented in the course.* Very Weak Weak Neutral Strong Very Strong Rate your ability AFTER the course to utilize the knowledge/skills presented in the course.* Very Weak Weak Neutral Strong Very Strong We are sorry this course did not meet your expectations but we value your feedback! Please let us know how we can improve in this area. Please provide your honest review of this course for others: What did you appreciate/enjoy about and/or learn from the course? What would your “testimony” be to others who are considering this course?* Would you give your permission for IAOM and/or this session's presenter, to use your feedback, with your name, in future promotional materials?* Yes, first and last name Yes, but first name only No We truly value your feedback. Please let us know how we can improve! What suggestions would you offer for improving this program? How will you utilize the knowledge and skills gained from this course to improve your practice? CEU and/or Certificate choices: I attest:* I have completed all course requirements to earn the prescribed CEUs and/or Certificate of Completion according to the standards of my professional organization. Please enter your full name. (must match your name from registration)* First Last Please enter your email address (must match your email from registration)* In which profession(s) do you hold licensure?* Speech-Language Pathologist Dental Hygienist Dentist Occupational Therapist Physical Therapist SLP Assistant OT Assistant Dietician/Nutritionist Nurse Teacher Other Please list your other profession(s) separated by commas:* SLP Certificate and CEU Options* Generate my certificate and submit my completion to ASHA for CEUs. Note that by requesting ASHA CEUs you give consent to have your personally identifying information shared with ASHA for the purpose of awarding ASHA CEUS. Generate my certificate only. I do not desire ASHA CEUs. AGD Course Attendance Verification Form* Generate my AGD Course Attendance Verification Form. Certificate of Completion* Generate my Certificate of Completion HiddenCourse Title Line One HiddenCourse Title Line Two HiddenPresenter HiddenLength HiddenCompletion Date MM slash DD slash YYYY HiddenAGD Subject Code HiddenAGD Verification Code
