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The Steep Climb (A Heart Failure Summit) - Post Summit Evaluation
A Feedback Form for Summit Participants
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Greetings dear Summit delegate!
To help the organizers further improve future educational activities, kindly spare a few moments to share your most precious inputs and feedback. Thank you!
By accomplishing this online survey, I am also voluntarily signifying my consent to communicate my opinions via this online method and have the anonymized results (no individual identifiers) of this survey utilized by UPCAAI for educational as well as possible research purposes.
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I agree
I do not agree
Q1. Place (region) of clinical practice
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Choose
NCR (National Capital Region)
CAR (Cordillera Administrative Region)
Region I (Ilocos)
Region II (Cagayan Valley)
Region III (Central Luzon)
Region IV-A (Calabarzon)
Mimaropa (Southwestern Tagalog)
Region V (Bicol)
Region VI (Western Visayas)
Region VII (Central Visayas)
Region VIII (Eastern Visayas)
Region IX (Zamboanga)
Region X (Northern MIndanao)
Region XI (Davao)
Region XII (Soccsksargen)
Region XIII (Caraga)
BARMM (Bangsamoro)
Q2. Type of professional practice
*
Choose
Physician (Primary Care, Family Medicine, General Practice)
Physician (Internal Medicine)
Physician (Specialist - Non Cardio)
Physician (Specialist - Cardiologist)
Paramedical or Allied Professions
Medical Trainee (Student, Resident, Fellow)
Q3. Years in practice
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< 5
5 - 10
> 10 but < 20
20 or more
Q4. Kindly rate the following aspects of the event. (1-lowest, 5-highest)
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1
2
3
4
5
Scientific program content
Faculty selection (panelists and moderator)
Live panel discussions
Audiovisual aspect
Publicity and registration
Time management
1
2
3
4
5
Scientific program content
Faculty selection (panelists and moderator)
Live panel discussions
Audiovisual aspect
Publicity and registration
Time management
Q5. Kindly rate the following panel discussion segments (1-lowest, 5-highest)
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1
2
3
4
5
Burden of Heart Failure (Day 1)
Approach to Diagnosis (Day 1)
Nonpharmacologic Strategies (Day 1)
Standard of Care (Day 1)
Recent Therapies (Day 1)
Latest and Emerging Drugs (Day 2)
Rationalizing Treatments (Day 2)
Invasive Interventions (Day 2)
Overall Approach to Care (Day 2)
1
2
3
4
5
Burden of Heart Failure (Day 1)
Approach to Diagnosis (Day 1)
Nonpharmacologic Strategies (Day 1)
Standard of Care (Day 1)
Recent Therapies (Day 1)
Latest and Emerging Drugs (Day 2)
Rationalizing Treatments (Day 2)
Invasive Interventions (Day 2)
Overall Approach to Care (Day 2)
Q6. Kindly rate the following industry segments (1-lowest, 5-highest)
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1
2
3
4
5
Journey Across the Heart Failure Continuum (Novartis)
Heart Rate Reduction in the Optimization of Care (Servier)
Energizing Strategies to Save the Failing Heart with Reduced Ejection Fraction (Boehringer)
Novel Interventions in Heart Failure Management: What is the Evidence? (Astra)
1
2
3
4
5
Journey Across the Heart Failure Continuum (Novartis)
Heart Rate Reduction in the Optimization of Care (Servier)
Energizing Strategies to Save the Failing Heart with Reduced Ejection Fraction (Boehringer)
Novel Interventions in Heart Failure Management: What is the Evidence? (Astra)
Q7. I would like to receive new updates regarding heart failure from the organizing team and I consent to receiving such updates via my registered email address.
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yes
no
Send me a copy of my responses.
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