Course Name --A Problematic Blood Transfusion-- 1.0 CE Course # DL-928
Name ____________________________________ CLS Lic. # _____________ Date ___________
Signature (Required) ________________________________________________________________
Address _________________________________________________________________________
Street City State/Zip
Payment Method ___ Check or ___Credit Card # _________________________ Type -Visa / MC
1.0 CE Fee: $12.00 (Member); $15.00 (Non-Member)
Exp. Date _________ Signature ____________________________
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According to state regulations, this evaluation must be completed and returned in order to receive CE hours. Your comments help us to provide you with better continuing education materials in the distance learning format. Please circle the number that agrees with your assessment.
1. Overall, I was satisfied with the quality of this Distance Learning course.
(strongly agree) 5 4 3 2 1 (strongly disagree)
2. The objectives of this Distance Learning course were met.
(strongly agree) 5 4 3 2 1 (strongly disagree)
3. The difficulty of this Distance Learning course was consistent with the number of CE hours.
(strongly agree) 5 4 3 2 1 (strongly disagree)
4. I will use what I learned from this Distance Learning course.
(strongly agree) 5 4 3 2 1 (strongly disagree)
5. The time to complete this Distance Learning course was: __________ hours
6. Please comment on this Distance Learning course on the back of this sheet.
What did you like or dislike?