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Continuing Education for Nurses 

585-360-4192

Evaluation of Eye Care Form

Please complete this form and you will receive your certificate.

Wilson Shepard Education Associates

80 Brandywine Lane, Rochester, New York 14618

(585) 360-4192 ~ FAX (585) 301-4457

EVALUATION FORM

Instructions: Please complete the following statement by selecting the one number that describes your rating.
The rating scale rates from 1 to 4, where 1=poor, 2=fair, 3=good, 4=excellent