Q1I am a(n)...
 MD/DO NP PA RN PharmD Other
Q2How many years have you been in practice?
 1-5 6-10 11-15 16-20 Over 20
Q3Please describe your practice setting:
 Solo Practice Group Practice Hospital Setting Clinic Other
Q4Number of patients seen per month with T2DM
 1-10 11-20 21-30 31-40 41-50 Over 50
Q5Please rate the following:
 Unsatisfactory Needs Improvement Average Above Average Excellent
 Degree to which educational expectations met    
 Material was relevant to my practice    
 Effective Faculty Presenters    
 Overall Program    
Q6As a result of what you have learned during this program, will you change your practice behaviors?
 No Unlikely Unsure Probably Absolutely
Q7What changes will you make to your practice behaviors?
Q9What barriers to change do you foresee, if any? Select all that apply.
 Cost Insurance Coverage Formulary Time with Patient Patient compliance Other
Q11Did the content contribute valuable information that will assist in improving patient outcomes?
 Strongly Disagree Disagree Neutral Agree Strongly Agree
Q12Please rate your ability to achieve the Learning Objectives of this presentation:
 Not at all Somewhat Mostly Completely
Q13What was your level of expertise on this topic?
 None Little Some Considerable Extensive
Q14Do you believe the activity was fair and balanced, free from commercial influences?
 Yes No
Q15Did the program increase your competence?
 Yes No
Q16Ambulatory Glucose Profiles for all CGM devices are available from the same website.
 True False
Q17What is the desired glucose variability for a patient with diabetes?
 ≤10 ≤25 ≤36 ≤70
Q18How confident are you in your answer to the last question?
 Not at all Somewhat Confident Very confident

dividing line