Down on the Pharm 1:
Post Test and EvaluationPrint this document and complete for program CEUs
Please provide the following information:
Name:______________________________________________________
Address:____________________________________________________
City:______________________ State:________________ Zip:_______
Phone:_______________________
Employer:___________________________________________________
Job Title:____________________________________________________
Post Test
Circle the correct answer based on the program.
Evaluation:
Circle the most appropriate response
The "Down on the Pharm 1" program:
a. strongly agree b. agree c. disagree d. strongly disagree e. unsure
a. strongly agree b. agree c. disagree d. strongly disagree e. unsure
a. strongly agree b. agree c. disagree d. strongly disagree e. unsure
a. strongly agree b. agree c. disagree d. strongly disagree e. unsure
a. strongly agree b. agree c. disagree d. strongly disagree e. unsure
a. strongly agree b. agree c. disagree d. strongly disagree e. unsure
Comments:
Once you have completed the Post Test and Evaluation, mail them along with a self addressed, stamped envelope to:
Terri Norris, EMS Coordinator
C/O Emergency Center
Community Hospital
2615 E. High St.
Springfield, Ohio 45505