This brief follow-up survey is to assess knowledge retention and determine your progress in making practice changes that were influenced by this activity. Please complete both sections below. An * indicates the field is required. At the end of the survey, click the Submit button.

Test Questions

Test questions enable us to accurately measure outcomes for this activity. Responses are collected from participants one week prior to the activity, at the conclusion of the activity, and 3-months post-activity. To fulfill the final step of this process, please select the correct answer for the following test questions.

John is a 33-year-old man who presents for a new patient appointment. He is accompanied by an unrelated adult. He is smiling and nicely dressed, but instead of answering your questions, he repeats the last word or two of your question. The person accompanying him says that John lives in group home and he was only told to get him to your appointment on time (which he did!).
Anthony is a 55-year-old man with Down syndrome. His brother brings Anthony to your office reporting that he has begun refusing to go to his favorite bookstore like he used to, spends a lot of time sleeping, is grumpy around his nieces and nephews and almost always forgets to call on their usual day of the week.
Mary is a 20-year-old woman with mild intellectual disability. She has been working at a job at a department store helping to arrange merchandise. Her sister accompanies her to your office to report that lately Mary has been spending all of her paycheck without worrying about what bills she needs to pay, her sleep pattern is "off" and she has begun accepting dates from multiple men who she absolutely does not know. Her sister is worried about this change in her usual behavior.
Please explain your 'Other Commitment to Change'.
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