CNE Evaluation – MOBI & TIES QI Training (2/28/18)

Name *

First

Last Name *

Last

Credentials *

Practice/Organization *

Email Address *

Phone Number *

Address *

Address 2

City *

State *

Zip *

Describe recent changes in immunization recommendations and MOBI/TIES Program *

Yes

Present MOBI/TIES slides effectively *

Yes

Integrate quality improvement strategies into your MOBI/TIES Presentation *

Yes

Assist attendees in the Plan-Do-Study-Act (PDSA) cycle

Yes

By signing or typing your name, you confirm your identity and attest to attending the entire educational activity. *