CSiI Accreditation and Evaluation of

Teaching and Learning Standards Form

Instructions to fill the form:
1. This form must be completed be handed over at the registration desk in
order to receive your attendance and CME points certificate.
2. No column must be left blank in order to complete this form.
Name of the event:
Date and Place of event :
Name of the attendee:.
Professional status:
Work place:..
Rate from 1 5: Poor (1); Fair (2); Average (3); Above average (4);
Excellent (5)
1. Usefulness to improve my practice:
2. Quality of the scientific content: :..
3. Quality of presentation:.
4. Quality of the organization:.
5. Was there any commercial or promotional bias evident in the CME
Course?

Yes / No

6. Additional comments: :

Email of the attendee:

Mobile or Landline number: