Skip to main content
205-638-9100
Close
In this section
Back
Main Menu
Locations
Emergency Department
Pediatric Practices
Surgery Centers
Outpatient Centers
Programs & Services
Patients & Visitors
Clinics
Visitation
Planning Your Visit
Online Pre-Registration
Patient Billing Information
Patient Name Change Request Form
Financial Assistance
Request Medical Records
Request Medical Records (PDF)- English
Request Medical Records (PDF)-Spanish
Immunization Schedule
Immunization Catch-up Schedule
Find a Provider
Ways to Help
Support Children's
Volunteer Services
Donate Now
About Children's
For Healthcare Professionals
Careers
Newsroom
Español
View All
Dismiss Modal
Close
205-638-9100
About Children's
For Healthcare Professionals
Careers
Newsroom
Español
Locations
View All
Emergency Department
Pediatric Practices
Surgery Centers
Outpatient Centers
Patients & Visitors
Clinics
Visitation
Planning Your Visit
Online Pre-Registration
Patient Billing Information
Patient Name Change Request Form
Financial Assistance
Request Medical Records
Request Medical Records (PDF)- English
Request Medical Records (PDF)-Spanish
Immunization Schedule
Immunization Catch-up Schedule
Ways to Help
Support Children's
Volunteer Services
Locations
Programs & Services
Patients & Visitors
Find a Provider
Ways to Help
Donate Now
search
show off canvas menu
The Children’s of Alabama is accredited by the Medical Association of the State of Alabama to provide continuing medical education for physicians.
Date
Name
Credentials
Credentials
- Select -
M.D.
D.O.
CRNP
RN
Other…
If Other, please specify:
Email Address
Name of Practice
Street Address
City
County
State
- Select -
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Evaluation Questions
1. One or more of the above stated objectives were met during the session.
Completely
Partially
Not at all
2. Was the activity free of commercial bias?
Yes
No
A commercial interest is any entity producing, marketing, re-selling or distributing healthcare goods or services consumed by, or used on, patients.
If no, please explain:
3. How likely are you to make a change as a result of this activity?
Very likely
Considering making a change
Already practice it
Not relevant to my practice
Not likely
4. What changes will you make?
5. What one idea from the activity did you think was the most beneficial to you?
6. What idea would you have liked to have had discussed further?
7. Based on a previous activities, describe a specific instance of how you applied the knowledge to patient care, research, or quality/systems improvement:
8. General comments:
9. Suggestions for future activities (please include why):
By providing your name/contact information above, the CME Committee can contact you for further information.
Leave this field blank