3 SIMPLE QUESTIONS
CME SURVEY

Help us to provide you with CME content that truly meets your needs. Please complete this simple survey and then click the “Submit” button at the bottom of the page.
1. Which of the following would best describe the majority of your practice:
  Primary care - pediatric
  Primary care - pediatric and adult
  Primary care pediatric and subspecialty pediatric
(describe specialty)   
  Subspecialty pediatric
(describe specialty)   
  Other   
2. Have you ever attended a UCMG CME conference in Hawaii?
  Yes
  No
Are you likely to attend a conference in the near future?
 1   2   3
(Legend: 1 = No, 2 = Maybe 3 = Yes)
Why or why not? 
3. Please let us know what topics you would like to hear at a conference:
Provide your level of interest for each topic:
1 = Low  2 = Medium  3 = High
Adolescent Medicine   1   2   3
Allergy/Immunology   1   2   3
Cardiology   1   2   3
Complimentary and/or 
Alternative Medicine 		  1   2   3
Dermatology   1   2   3
Developmental 
& Behavioral 
Pediatrics 		  1   2   3
Emergency Medicine   1   2   3
Endocrinology   1   2   3
ENT   1   2   3
Gastroenterology   1   2   3
Hematology/Oncology   1   2   3
Infectious Diseases   1   2   3
Neonatology   1   2   3
Nephrology   1   2   3
Neurology   1   2   3
Ophthalmology   1   2   3
Orthopedics   1   2   3
Pediatric Surgery 
(General) 		  1   2   3
Pulmonology   1   2   3
Radiology   1   2   3
Rheumatology   1   2   3
Toxicology   1   2   3
Urology   1   2   3
Specific topics and/or 
other comments: 


University Childrens Medical Group
6430 Sunset Boulevard, Suite 600
Los Angeles, CA 90028-7900


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