Orthotown November 2023 - 63

CONTINUING
EDUCATION
ANSWER
SHEET
Expand Your Reality
By Dr. Michael K. DeLuke
License Number _______________________________________________________________________
AGD# _______________________________________________________________________________
Name ________________________________________________________________________________
Address ______________________________________________________________________________
City ________________________________________________ State _________ZIP _______________
Daytime phone ________________________________________________________________________
Email (required for certificate) ____________________________________________________________
❏ Check (payable to Orthotown)
❏ Credit Card (please complete the information below and sign; we accept Visa, MasterCard and American Express.)
Card Number ______________________________________________________________________
Expiration Date (Month / Year) _______ / ________
Signature _____________________________________________________ Date _______________
Instructions: To receive credit, complete the answer sheet and mail it, along with a check
or credit card payment of $36, to: Orthotown, 9633 S. 48th St., Suite 200, Phoenix, AZ 85044.
You may also fax this form to 480-598-3450 or answer the post-test questions online at
orthotown.com/deluke2. This written self-instructional program is designated for 1.5 hours
of CE credit by Farran Media. You will need a minimum score of 70% to receive your credits.
Participants pay only if they wish to receive CE credits; thus no refunds are available. Please
print clearly. This course is available to be taken for credit Nov. 1, 2023, through its expiration
on Nov. 1, 2026. Your certificate will be emailed to you within 3-4 weeks.
CE POST-TEST
Please circle your answers here.
1. A B C D
2. A B
3. A B C D
4. A B C
5. A B C D
6. A B C D
7.
A B C D
8. A B C D
9. A B C D
10. A B C D
Program Evaluation (required)
Please evaluate this program by circling the corresponding numbers: (5 = Strongly Agree to 1 = Strongly Disagree)
1. Course objectives were consistent with the course as advertised.
2. Course objective #1 was adequately addressed and achieved.
3. Course objective #2 was adequately addressed and achieved.
4. Course objective #3 was adequately addressed and achieved.
5. Course objective #4 was adequately addressed and achieved.
6. Course objective #5 was adequately addressed and achieved.
7. Course material was up-to-date, well-organized, and presented in sufficient depth.
8. Instructor demonstrated a comprehensive knowledge of the subject.
9. Overall, I would rate this course (5 = Excellent to 1 = Poor):
10. Overall, I would rate this instructor (5 = Excellent to 1 = Poor):
5
5
5
5
5
5
5
5
5
5
4
4
4
4
4
4
4
4
4
4
3
3
3
3
3
3
3
3
3
3
2
2
2
2
2
2
2
2
2
2
1
1
1
1
1
1
1
1
1
1
Comments (positive or negative): ________________________________________________________________________________________
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
For questions, contact Director of Continuing Education Nareg Apelian at nareg@farranmedia.com.
NOVEMBER 2023 | 63 | ORTHOTOWN.COM
http://www.orthotown.com/deluke2 http://www.ORTHOTOWN.COM
Orthotown November 2023

Table of Contents for the Digital Edition of Orthotown November 2023
