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CME Self-Assessment Exam
Answering Sheet and Evaluation/Certification

 

Click here for CME Instructions.

After finishing this exam:

  1. Check your answers with the correct answers published in the Journal .
  2. Complete the CME Evaluation and Certification section that follows the answering sheet to receive and print your CME certificate.
  3. This educational activity must be completed by December 31, 2009.
Journal Issue Month and Year:
CME Article Number:
CME Article Author’s Name:
Journal Volume Number:
Journal Issue Number:
Question 1: A
B
C
D
E

 

Question 2: A
B
C
D
E
 
Question 3: A
B
C
D
E

 

Question 4: A
B
C
D
E
 
Question 5: A
B
C
D
E

 

Question 6: A
B
C
D
E
 
CME EVALUATION AND CERTIFICATION
1. Was the article consistent with the stated objectives? POOR
SATISFACTORY
OUTSTANDING
2. Did reading this article prepare you to achieve its stated objectives? POOR
SATISFACTORY
OUTSTANDING
3. Is reading this article likely to enhance your professional effectiveness? POOR
SATISFACTORY
OUTSTANDING
4. Was the article format conductive to learning? POOR
SATISFACTORY
OUTSTANDING
 
Suggestions for future topics:

I certify that I have met the criteria for CME credit by studying the designated materials, by responding to the self-assessment questions, by reviewing those parts of the article dealing with any question(s) answered incorrectly, and by referring to the supplemental materials listed in the references. This educational activity is designated for 1 1/2 category 1 CME credits.

Indicate total credits claimed: (maximum of 1 1/2 credits)

Do you have an individual subscription to the Journal? Yes No

You must complete the credit card information below for a payment of $15 for your exam.

Payment Type:
Cardholder Name: (as it appears on card)
Credit Card Number:
Expiration Date: (mm/yy)

Please provide your name as it should appear on your certificate of credit and also provide your mailing address. Your CME certificate will be ready for printing after your information is submitted.

Prefix First Name Middle Initial

Last Name Suffix Degree
Position:
Institution/Affiliation:
Street Address:
City: State: Zip:
Phone:
Fax:
Email:

 

 

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