STOP HUS Conference

Please fill this out and return it to the registration desk before leaving the conference!

Please circle the category that best describes you:

1.	I survived HUS
2.	My child or relative or friend survived HUS
3.	My child or relative had HUS and did not survive.
4.	I treat children who have HUS or survived HUS
5.	I wanted CME credit and was interested in the subject
6.	I am a member of a public health department
7.	I am a member of the press
8.	I work with a company that caused an outbreak
9.	My work/volunteer work concerns people who have had HUS
10.	I was interested in the subject for medical or research purposes
11.	Other __________________________________

1) Before the conference, what categories of potential sequelae were of greatest concern to you?

digestive tract _____

sensory deprivation _____

reproductive _____

heart/blood _____

kidney _____

motor coordination _____

hormones _____

earning deficits _____

nutritional deficits _____

emotional deficits _____

none in particular _____

other _____

Please describe "other": ______________________________________________________________

____________________________________________________________________________________

2) Was the glossary you received before the conference helpful?

Yes____ No____

3) Did you learn something new about how HUS unfolds during the acute phase of illness?

Yes____ No____

4) Did you learn about the tradeoffs of the use of plasma transpheresis?

Yes____ No____

5) In general, do you now feel you understand how the acute phase of HUS unfolds better than you did before the conference?

Yes____ No____

6) Will you discuss information you gained at this conference with your child's doctor(s)?

Yes____ No____ N/A____

7) Did you learn anything that will help you get better treatment for your child/patient?

Yes____ No____ N/A____

If so,what? ______________________________________________________________________

_______________________________________________________________________________

8) On a scale of 1 to 10, compared to what you were told about sequelae when your child was discharged from the hospital or what you knew before the conference, would you say that at this conference you learned:

Almost nothing new	1
	2
	3
	4
	5
	6
	7
	8
	9
A tremendous amount	10
	N/A or N/R

9) On a scale of 1 to 10, how enthusiastically would you recommend that a parent or physician dealing with a child with HUS review the proceedings for this conference, which will be available on the internet?

Don't bother	1
	2
	3
	4
	5
	6
	7
	8
	9
An absolute must	10
	N/A or N/R

10) What questions do you still have?

____________________________________________________________________________________

11) What else would have improved your experience? Do you have any other advice for us? ____________________________________________________________________________________

____________________________________________________________________________________

Thank you very much!

	Copyright 2000 \| Reprint Policy
	Last Modified: September 1, 2001