CNE/CPD Evaluation/Survey

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[1(one) CNE/CPD/Contact Hour]]

*Omicron Delta is an approved provider by the California Board of Registered Nursing - CEP#16709

*Certificates will be awarded/emailed within 90 days

Email *

Attendee name to appear on CE Certificate:
*

Registered Nursing (RN)/Professional License Number:
*

I am a member of the following Sigma Chapter(s):
*

Please enter/type the TITLE of the Webinar presentation for which you are seeking credit or recognition:
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Did you attend the ‘live’-viewing of the Webinar when it was initially presented?

*Please note: if you attended the ‘live’-viewing, or previously viewed this presentation ‘asynchronously,’ CNE/CPD credit will not be awarded for a second time.

Yes, I attended the ‘live’ Webinar and also viewed this presentation ‘asynchronously.’

No, I did not attend the ‘live’ presentation and viewed it ‘asynchronously’ for the first time.

No, I did not attend the ‘live’ presentation, but I have previously viewed it ‘asynchronously’ and have just viewed the recording again.

Including yourself, please enter the total number of individuals that viewed this presentation recording. (In other words: if any colleagues, friends, or family watched the presentation along with you, please enter the total number of attendees below. If you viewed the recording alone, please write “1(one) attendee.
*

Please indicate if you are seeking CNE (Continuing Nursing Education), CPD (Continuing Professional Development), both CNE and CPD, or a Certificate of Attendance.

*Please note: at this point in time CPD is currently pending in the Philippines.

I am seeking CNE credit.

I am seeking CPD credit.

I am seeking both CNE and CPD.

I am seeking a Certificate of Attendance.

I am NOT seeking CNE, CPD, or a Certificate of Attendance.

Attainment of stated objectives:
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Objectives were fulfilled.

Objectives were partially fulfilled.

Objectives were not fulfilled.

Attainment of my expectations:
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My expectations were fulfilled.

My expectations were partially fulfilled.

My expectations were not fulfilled.

The information on Implicit Bias will be helpful to me.
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This information will be VERY helpful.

This information will be SLIGHTLY helpful.

This information will be MINIMALLY helpful.

This information will NOT be helpful.

Not applicable to me at this time.

How applicable was the information presented?
*

Not applicable.

Very applicable.

Current specialty, department, or area of practice:
*

Additional questions/comments:

I am interested in future webinar topics on or about:

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