Fall Symposium 2021 - Module 2 (Oct 13) Evaluation Thank you for completing this form, to help CAMAP improve this program and meet the requirements of CFPC and the Royal College. If you would like a CPD certificate for your records, please make sure you include your first and last name and email address. The certificate will be automatically emailed to you after you submit the form.Name (required if you would like a CPD certificate) First Last Email address Please enter your email address if you'd like us to send you a CME certificate.1. Please tell us what your designation is(Required) Family Physician Nurse Practitioner Specialist Other clinician Non clinician 2. What is your role in the delivery of MAiD services?(Required) Assessor Provider Both assessor and provider I do neither role Care Coordinator 3. What changes will you be making as a result of this module?4. What part of this module did you find the most effective? 5. What part did you find the least effective? 6. Was there adequate time for discussion?(Required) Yes No 7. Did the speakers disclose their respective Conflicts of Interests?(Required) Yes No 8. Did you perceive any degree of bias in this program?(Required) Yes No 9. If you answered "yes" to the question above, please explain the bias you perceived 10. For participants from Quebec, does the content respect the Code of Ethics of the CQDPCM (http://cqdpcm.ca/tool/code-dethique/)?(Required) Yes No Not applicable as I do not live / work in Quebec 11. Please indicate which of the CanMEDS-FM Roles you feel were addressed by your participation in the Webinar. Please select all that apply. (This question is required by CFPC; if you are not a family physician, you can note that below).(Required) I am not a family physician Family medicine expert Communicator Collaborator Leader Health Advocate Scholar Professional 12. What additional training would you like on this topic?Thank you for completing this evaluation form!