This report should contain the information listed below and must be sent to the EORNA ACE within 4 weeks after the programme has taken place.

Event title:

Reference number:

Actual number of participants:

Number of certificates issued:

Disclosure of conflict of interest:

Number of potential conflicts reported:

Number of potential conflicts reported by participants:

Summary of the Evaluation forms and comments from participants. How many were collected and analysed:

Main conclusions (usefulness, educational value, quality of content and speakers)

I confirm that the above report will be submitted within 4 weeks of this event.

Printed title and name of the course director:

Signature: …………………………. (Electronic Signature)

Date:

Add to Application

You can print this window or complete an EORNA ACE for educational event ELECTRONIC APPLICATION FORM when you click here

Please complete this form 4 weeks after event
Event Report Agreement - electronic application form (final): click here