Dialysis Essentials

Participant Evaluation Form – Dialysis Essentials

Please complete upon conclusion of the activity. Your responses help us improve future programs.

Overall Activity Evaluation

Please answer by checking the appropriate rating, where 5 = Outstanding, 4 = Good, 3 = Satisfactory, 2 = Fair, and 1 = Poor.
Content related to my scope of practice 5 4 3 2 1
Content met my expectations 5 4 3 2 1
I plan to make changes in my practice based on the information in this activity.
Please explain:
Yes, planned changes include (check all that apply):
Modify my approach to treatment, referral or co-management
Modify my patient education information/materials
Modify elements of staff training or treatment protocols in my practice
I would recommend this activity to my peers Yes No
How did you learn about this activity?
Brochure E-mail Professional Journal
NKF Web site Co-Worker Direct Mail
Don't Recall Other:
I would like the following topics/issues to be addressed in future activities (select all that apply):
Adequacy of dialysis Anemia
Autoimmune disease Cardiovascular disease
CKD Risk Awareness/Risk Reduction Diabetic kidney disease
Dyslipidemias Depression
Glomerular disease Peritonitis
Hypertension Kidney transplant
Mineral and bone disorders Patient Education/Adherence