VIFSM -

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Your Information

Name:

First:

Last:

Contact:

Title:

Email:

Online Training Course Information

1. Would you take advantage of online training to receive CME's?

Yes

Maybe

2. Do you have access to the internet?

Yes

3. If you do have access to the Internet, do you use a dial-up modem or a high-speed connection?

Dial-Up

High-Speed

4. The online training will consist of several different sessions. What would be your attention span to focus on a single session?

10 minutes

15 minutes

20 minutes

25 minutes

30 minutes

5. Have you referenced the Medical Examiner's Handbook?

Yes

N/A

6. If you have referenced the Medical Examiner's Handbook, has it been valuable?

Extremely valuable

Very valuable

Valuable

Somewhat valuable

Not at all valuable

7. Where would you most likely take the course?

Home

Office

Library

Friend's Home

Other

8. Would you be willing to participate in our "Beta Advisory Group" for testing the online training?

Yes

9. Do you have any additional comments to provide on the online training for medical examiners?