Your feedback is important to us. We use your comments to help develop future educational programs.

Teleconference Program Evaluation
*1. Please rate your knowledge of IBD on a scale of 1 to 5. (Please select one answer for each.)
5=Extremely Knowledgeable 4=Knowledgeable 3=Somewhat Knowledgeable 2=Very Little Knowledge 1=No Knowledge
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Knowledge about IBD before the program
Knowledge about IBD after the program
*2. Please rate this program on a scale of 1 to 5. (Please select one answer for each.)
5=Outstanding 4=Good 3=Satisfactory 2=Fair 1=Poor
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Overall program
Convenience of teleconference format
Effectiveness of faculty speaker
Helpfulness of Q&A session
*3. Following this program, do you feel more prepared to discuss inflammatory bowel diseases with your healthcare provider?


*4. How did you find out about the program? (Please select one.)







  
*5. What topics would be of interest for future educational programs?









  
*6. What time of day do you prefer to participate in upcoming programs?


What time zone are you in?



*7. Would you participate in another CCFA teleconference?

*8. Have you been diagnosed with any of the following:



  
*9. When were you diagnosed with Crohn’s disease or ulcerative colitis?






*10. Did you participate in this program to gather information for:





*11. What is your age?





*12. What is your gender?

13. How can we improve this program and any other comments?
Internal use only:

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