0920-1154 Pediatrician - ECHO Session Satisfaction Survey

F orm Approved

OMB No. 0920-1154

Exp. Date 1/31/2023

AAP Neurodevelopment ECHO Post Session Evaluation

Thank you for participating in the AAP Neurodevelopment ECHO program. The AAP Neurodevelopment ECHO will serve as a forum for staff from pediatric primary care practices to develop knowledge and capacity to improve the monitoring, screening and follow-up care for children aged birth through 8 years with functional impairments of neurocognition, self-regulation, and adaptive functioning.

To help us meet your needs, please provide us with feedback on the session that you recently attended.

1. Session date

2. Which of the following best describes your training?

Physician (MD, DO) Nurse Practioner Physician Assistant Nurse

Social Worker

Other (please specify)

Public reporting burden of this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to - CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333 ATTN: PRA (0920-1154).

3. Please rate this TeleECHO session on the statements listed below.

Poor Fair Good Very Good Excellent

How well did the session deliver balanced and objective, evidence- based content?

Opportunities to ask questions were:

The pace of the session was:

The organization of the presenter's presentation was:

The presenter's ability to clearly communicate was:

The relevance of the presentation to this session's objective was:

3. Do you feel that this session conveyed any commercial bias?

No

If Yes, please comment

3. What did you like best about this session?

3. What did you like least about this session?

3. Please list any additional topics you would like to discuss in future AAP Neurodevelopment ECHO sessions.

1