21 ONE Conf – General Session 2 – Add On CEs

2021 ONE Conference (Session #2) Evaluation:
Thank you for your time. This survey will only take you a FEW minutes to complete. Please note, that each individual requesting a Continuing Education Certificate must complete a separate evaluation form.
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Title of Conference*
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Module:
Can put the company's name if applicable. Will appear below the title of the webinar on the CE certificate. Must remove sample name.
Evaluate the Presentation Style and Content --*
Natalie Hunt, CRNP, NNP-BC, C-NNIC
Excellent Very Good Good Fair Poor
The instructor’s ability to explain was
The pace of the material presented was
The content was clear and easy to follow
The content was presented without commercial bias

Evaluation of Objectives -- Rate how well the presentation met the following learning objectives.*

Understanding and Promoting Sleep in Preterm Infants

	Excellent	Very Good	Good	Fair	Poor
Identify 3 stages of sleep in the preterm infant
Describe two or more negative effects of sleep deprivation in preterm infants
Describe at least one strategy to promote sleep in the NICU

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Continuing Education & Certificate Information
Complete the information below to receive a certificate of Participation & Continuing Education. By entering your information below, you certify that you have personally watched the complete conference presentations for a total of 3 hours or more, that you are entering this information after doing so, and that you are submitting this form only for yourself.
Name*
First Last
Job Title/Credentials
Please provide your State License # (this will appear on the CE Certificate)
Enter any other comments here. Thank you for your time!

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Billing Name*
First Last
Email*
Your PDF Certificate will also be sent to this email
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Credit Card*
Card Details
Cardholder Name
Add On CEs
Total
$0.00
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Course Code Prefix*

These numbers will show BEFORE the course code on the template.
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Template Color - be sure to match to the company color*

(Don't forget the #)
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Number of Units Earned*

(Example: 1 hour, 3 hours, 10 magic beans -- be sure to add the measurement)

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2021 Virtual ONE Conference

	Excellent	Very Good	Good	Fair	Poor
The instructor’s ability to explain was
The pace of the material presented was
The content was clear and easy to follow
The content was presented without commercial bias

	Excellent	Very Good	Good	Fair	Poor
The instructor’s ability to explain was
The pace of the material presented was
The content was clear and easy to follow
The content was presented without commercial bias

	Excellent	Very Good	Good	Fair	Poor
Describe two examples of the variability in policies related to parental presence n the NICU during the COVID-19 pandemic
Discuss at least two strategies to increase parental presence in the NICU
Outline at least two emotional and/or developmental implications of restricting parental presence in the NICU

	Excellent	Very Good	Good	Fair	Poor
The instructor’s ability to explain was
The pace of the material presented was
The content was clear and easy to follow
The content was presented without commercial bias