enrollment form

Home

Care

Provider

Answer/Enrollment Home study title: Osteoporosis: Test ID No.: HCP0297 Fee: $9 (payable by U.S. check Florida content: 2 IO3 Iowa criteria: #I

Primary

Prevention

or money

and

Form

Intervention

order)

Strategies for Women at Risk Expiration date: April I, 1999 CE credit: 1.0 contact hour

To receive continuing education credit for this issue, simply do the following: I. Read the article on pages 76-8 I. 2.Take the test and record your answers on the form below. (You may send photocopies 3. Mail the completed answer form and enrollment coupon, with check or money order must be included. Please do not send cash. The deadline for submitting your enrollment/answer form is April I, 1999. Instructions: Darken only one circle for your of spaces required for the test you are taking. 1.0 a Ob oc Od

2.0 Ob oc Od

a

3.0 Ob oc Od

a

4.0 Ob oc Od

a

ll.Oa Ob oc Od

lZ.Oa Ob oc Od

13.0 a Ob oc Od

14.0 a Ob oc Od

Program

evaluation:

answer

to each question.This

5. 0 a Ob oc Od 15.0

6. 0 a Ob oc Od a

16.0

Ob oc Od

Please rate this CE material

is a standard

form; use only the number

7.0 a Ob oc Od

8.0 a Ob oc Od

17.0 a Ob oc Od

18.0

a Ob oc Od

by darkening

of the answer form.) for $9 per test. Payment

the appropriate

a Ob oc Od

circles

below.

Middle

name

9.0 a Ob oc Od

10.0 a Ob oc Od

19. Oa Ob oc Od

20.0a Ob oc Od

I .The following objectives of the program have been accomplished: Discuss the effects of osteoporosis. 0 Yes 0 No Identify

recommendations

2. My expectations

have been met:

3.This

method

4.The

level of difficulty

5. It took

-

Please print

for postmenopausal

of CE is effective

hours

OYes

OYes

0 No

0 No

for the content

of this program to complete

women.

provided:

OYes

0 No

was

this program.

clearly

Last name

First name

Address City

State

Phone State(s)

Specialty

Social Security of licensure

ZIP

number

and license number(s)

area

Make check or money order Buchanan and Associates

APRIL 1997, VOL. 2 NO. 2

payable to

Mail to: Buchanan and Associates I 666 Garnet Ave., # IO2 San Diego, CA 92109

HOME

CARE PROVIDER

83