Dear Doctor (name):
In order to provide the best possible CME programs, we would ask you to take a moment to
evaluate the following program which you attended:
CME Topic: Date:
1. Please list any changes you have made in your practice on the basis of this program:
2. Did we meet your expectations for the program and how could we have better presented
3. Please recommend topics that you would like to have future programs address.
Robert L. Buckley, M.D.
Chair and Executive Director