EVALUATION

1. How would you rate the value of course content and topic covered? *

1 = Low to 5 = High

1

2

3

4

5

2. Do you think the content is useful for use in the clinic tomorrow? *

1 = Low to 5 = High

1

2

3

4

5

3. Are you interested in a second module on this topic? *

1 = Low to 5 = High

1

2

3

4

5

4. Would you recommend the course to a colleague? *

YES

NO

5. How would prefer to see the material? *

Please check all that apply and tell us why below if you wish:

Live

Online (webinar) based

Name *

First Name

Last Name

Years of Practice Experience *

Less than 1 year

1 to 3 years

3 to 5 years

5-10 years

More than 10 years

Which modules did you complete? *

Please check all that apply.

Module 1 (all)

Word (section)

Story (section)

Commitment (section)

Participation (section)

Module 2

Module 3

*

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