University of FloridaContinuing MedicalEducationUniversity of Florida,Departmentof PsychiatryGrandRounds

EVALUATIONFORMSection #6110 LIVE

Program:“Help for Hoarding: Update on Current Treatments for Hoarding Disorder”
Date:December 11, 2015

Speaker:Carol A. Mathews, MD

Yourcommentsareveryimportanttous!

Pleasecompletethisevaluationso thatwemayprovidemorequalityprogramsinthefuture.

Thank you for your feedback!

University of FloridaContinuing MedicalEducationUniversity of Florida,Departmentof PsychiatryGrandRounds

EVALUATIONFORMSection #6110 LIVE

Thetherapeutic recommendations presentedinthis activitydidnotencourageinappropriateorexcessiveuseofproducts/devices. Agree Disagree

Theinformation presentedin thisactivitydid notserveto advancea proprietaryinterestofany commercialentity.
AgreeDisagree

ExpectedClinicalOutcomes

1.Willinformationgainedfromthisprogramresultinenhancingoptimalpatientcare? Yes No

2.Ifyes,pleaselistchange(s)youintendtomakeinyourpracticeasaresultofthisprogram.

3. / Pleaserateyourconfidenceinimplementingthesechanges.
HighconfidenceModerateconfidenceLow/Noconfidence / N/A

4. Pleaseidentifyanybarriersyouperceiveinimplementingthesechanges(selectallthatapply) CostInsurance/reimbursementissues Lackoftimetoassess/counselpatients Patientcomplianceissues

Lackofadministrativesupport/resourcesLackofconsensusofprofessionalguidelines

5. Howwillyouaddressthesebarrierstoimplementchangesinknowledgeandbehavior?

Thank you for your feedback!

University of FloridaContinuing MedicalEducationUniversity of Florida,Departmentof PsychiatryGrandRounds

EVALUATIONFORMSection #6110 LIVE

BasicProgramEvaluation

5= Excellent/ 4= Good/ 3= Average/2= Fair/ 1= Poor

Thank you for your feedback!

University of FloridaContinuing MedicalEducationUniversity of Florida,Departmentof PsychiatryGrandRounds

EVALUATIONFORMSection #6110 LIVE

6. / Thematerialwaspresentedat anappropriatelevel. / 5 / 4 / 3 / 2 / 1
7. / I havegainedknowledgethatwillimprovepatientcare. / 5 / 4 / 3 / 2 / 1
8. / Theprogrammetmyexpectationsinaccomplishingthestatededucationalobjectives. / 5 / 4 / 3 / 2 / 1
9. / Youroverallratingofthequalityoftheeducationofferedat thisprogram. / 5 / 4 / 3 / 2 / 1

10.AdditionalComments/Explanations:

11.Howcanthisprogrambeimproved? (Pleaselistbothstrengthsandweaknesses.)

12.Basedonyoureducationalneeds,pleaseprovideuswithsuggestionsforfutureprogramtopicsandformats:

Thank you for your feedback!

University of FloridaContinuing MedicalEducationUniversity of Florida,Departmentof PsychiatryGrandRounds

EVALUATIONFORMSection #6110 LIVE

Program: “Help for Hoarding: Update on Current Treatments for Hoarding Disorder”
Date:December 11, 2015

Speaker:Carol A. Mathews, MD

Pleasecircle your title

MD DOPhDLCSWLMHCLMFTARNPRNLPN

MedicalStudentResident

FellowPsy.D.FacultyOther:

Please circle what type of credit is needed:CME CECEU

ThisformMUSTbecompletedandreturn by5pmthedayofthe presentationto:
Attn:Debra Krawczykiewicz or352-265-7983 (fax)

Thank you for your feedback!