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KU Area Health Education Centers
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Directions: Kansas AHECS (Pittsburg, Garden City, Hays) are committed to providing unique and high quality continuing education for health professionals in Kansas. Your input into this process is invaluable. Please respond to the following questions according to your individual needs for continuing education.

   If you would prefer to download the PDF form and mail it in, click here.

PART I. BACKGROUND AND CONTINUING EDUCATION (CE) NEEDS.
What is your profession?


MD
DO
ARNP
RN
LPN
ACHA
PT/OT
Resp
CDM
RD/LD
Radiology
EMS
Social Worker
Funeral/Embalmer


In what month do you renew your license?


How long have you been practicing?


Under 5 years
6-10 years
11-20 years
over 20 years

In which age category do you belong?


18 to 26 (Millenials)
27 to 42 (Generation X)
43 to 61 (Boomers)
62 and above (Mature)

What is your email address?


What county and state do you reside in?



What are your three top practice challenges
at the present time?




Please indicate the top three education topics
you would like to see addressed through CE.




What are the biggest challenges that you face in
obtaining CE hours?


PART II. PREFERENCES FOR CE.
Do you have Internet at work?


Yes
No

Do you have access to the Internet at home?


Yes
No

Do you have access to an ITV
(Interactive Television) site?


Yes
No


How do you most often learn about
CE offerings?


AHEC Monthly Calendar
Brochures received at home
Information posted at work
Friends and colleagues
Advertisements in professional newsletters and journals


For your most recent relicensure period,
how many hours of CE were obtained through programs
offered by your employment facility?


1-5 hours
6-10 hours
11-15 hours
16-20 hours
21-25 hours
26 or more

For your most recent relicensure period, how
many hours of CE were obtained through prescribed
certification programs (ACLS, PALS, TNCC, etc.)?


1-5 hours
6-10 hours
11-15 hours
16-20 hours
21-25 hours
26 or more

What length of program do you prefer?


1-2 hours
3-4 hours
5-6 hours
8 hours
2 days
length is not a factor

What time frame do you prefer?


All day
Afternoon only
Weekends
Morning only
Evenings only
My schedule is flexible

What is your average cost for registration,
per continuing education hour?


Please indicate, by percentage, what type of
programming you are CURRENTLY attending.









(The total of column should equal 100%)
Please indicate, by percentage, what type of
programming you would PREFER to attend.









(The total of column should equal 100%)
Thank you for taking the time to complete this survey!