Post-Course Survey | Buffalo Occupational Therapy

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Phone *

OT / OTA License Number (If Applicable)

Student ID # with Associated School (If Applicable)

Who are you? *

What do you hope to gain from this workshop? *

Level exposure do you currently have with 'topic of PD'? *

What OT/OTA program did/do you attend? And year of graduation. *

How did you find BOT Resources? *

The following objectives must be met to receive full credit for this PD : __________

I agree to the above learning requirements.

Anything else you want to share with us?

Cost for ' Name of Professional Development'

Price: $ 10.00

Total

$ 0.00

Stripe Credit Card

Card

Name on Card