CONTINUING MEDICAL EDUCATION (CME)

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					                                   CME ACTIVITY EVALUATION FORM


                                               AMA HIPPA School

                                            Securing PHI: Overview

As a result of participating in this activity, I am able to:

 Describe and understand responsibilities to comply with                  Disagree                        Agree
 updated HIPAA regulations                                                   1     2          3      4      5
 Incorporate new HIPAA guidelines into daily practice                     Disagree                     Agree
                                                                             1     2          3      4   5
 Understand enforcement of and penalties for non-compliance               Disagree                     Agree
 with HIPAA privacy and security rules                                       1     2          3      4   5

 As a result of participating in this educational activity:
          I will change my practice.                      How?



          I will not change my practice.                  Why?    This activity reinforced my current practice.
                                                                  Other (please explain):




 Overall, I would rate this activity:                                     Poor                           Excellent
                                                                            1        2        3      4       5

 Other comments, suggestions or recommendations for future activities:




In order to receive AMA PRA Category 1 Credit ™ for this activity please submit this evaluation along with
your credit claim form by fax, e-mail or standard mail to the following:


American Medical Association
Attn. Debbi Smith
515 N. State Street
Chicago, IL 60654
Fax (312) 464-4623
amahipaaschool@ama-assn.org

				
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