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Course Evaluation Form

*Seminar Title:
*Speaker:
*Sponsored By:
*Date:
1. What was your main reason for attending this course?
To gain new knowledge/skills
To review
To provide better service
To gain continuing education credit
Other
2. To what extent did the course meet your expectations?
Exceeded
Met completely
Met adequately
Did not meet
3. In what ways, if any, could the course better have met your expectations?
No improvement needed
More detailed information
More emphasis on techniques
More slides
Fewer slides
Other:
4. Was the course content consistent with the publicized title and description?
Yes
No
If No, Please explain:
5. Do you feel the course met its objectives?
Yes
Mostly
Partly
No
6. Will this course be of value to you in your practice?
Yes
Mostly
Partly
No
7. Was the amount of time allotted to cover the material appropriate?
Yes
Too little time
Too much time
8. Would you see this speaker again?
Yes
No
9. How did you hear about this program?
10. What other CE topics are of interest?
11. Would you like to be contacted for future CE programs?
Yes
No
Would you like us to send you the earned CE Credits from this program?
Yes
No
If Yes, How?
Email
Fax
Mail
Dr.
Email Address:
12. Kindly rate the following:
      5 = Excellent
      4 = Good
      3 = Average
      2 = Fair
      1 = Poor
Knowledge of the presenter:
Presentation skills of the presenter:
Training materials:
Organization of the presentation:
Food and refreshment (if applicable):
Lecture Facilities:
13. What did you like best about the course?
14. What did you like least?
15. Please give us any comments and/or suggestions you may have:
You have my permission to use the above comments with my name
in future promotional materials.
*Name:
*Credentials:
*Email Address:
We appreciate your feedback, and we hope your Keller/Meridian Center
experience was an enjoyable one!