CCFP Virtual CME On-Demand Review and Presenter Evaluation Survey

We sincerely appreciate your participation in the Caribbean College of Family Physicians (CCFP) Virtual CME On-Demand event accessed on our Zoom and/or YouTube platforms.

As part of our commitment to providing high-quality continuing medical education (CME), and especially our on-Demand events, we value your feedback on the presentations and overall experience

Survey Questions:

a. Full Name

First

Last

b. Years of Practice:

c. Contact Phone:

d. Contact Email:

On-Demand Review:

a. Have you reviewed the on-demand recordings from the CCFP Virtual CME event?

Yes

b. If yes, please list the events you reviewed, the date of the review, and the number of CME/CPD credits required for each event:

Presentation Evaluation:

Briefly review each presentation you have watched and provide constructive feedback.

Please rate 3rd presenter on a scale of 1-5 with 5 being the highest (if applicable)

Please rate 4th presenter on a scale of 1-5 with 5 being the highest (if applicable)

Please rate 5th presenter on a scale of 1-5 with 5 being the highest (if applicable)

Certificate Details:

a. For each event reviewed, please provide the name of the event and date reviewed.

For the event reviewed, please provide in your own words what you understand of the topics presented in each session.

CME Certificate Delivery:

a. CME certificates will be emailed after confirmation of your review of the recordings and completion of this form and receipt of confirmation of payment. Additionally, confirmation of payment should be sent to us via email at ccfpsecretary@gmail.com.

Please acknowledge Section 8 below

Acknowledged

Contact Information:

a. In case of any queries or issues, please feel free to reach us at:

Telephone: 876-517-6636 / 876-386-1443 (WhatsApp)

Email: ccfpsecretary@gmail.com

Thank you for your valuable feedback and commitment to professional development. Your input is crucial in enhancing our future CME events. If you have any questions or encounter any issues, please contact us using the provided contact information.

PAYMENT INFORMATION

a. The cost per certificate is J$2,000.00. Kindly make the payment using one of the following methods

This link to make payment

https://www.fygaro.com/en/pb/89664805-a7ff-4767-8041-05266518bd7c/

Bank Transfer:

BANK/BRANCH: NCB CONSTANT SPRING FINANCIAL CENTRE

A/C # & TYPE: J$ BUSINESS CURRENT - #331001678

A/C NAME: CARIBBEAN COLLEGE OF FAMILY PHYSICIANS (CCFP OR CCFPJ)

Please indicate completion of above

Completed

In progress

a. After making the payment, please provide confirmation/any transaction/reference number associated with your payment for verification purposes to: ccfpsecretary@gmail.com

Please confirm completion of above

Completed

In Progress

Payment

Month

Year

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