Evaluation Form

ALLWISE Continuing Education Evaluation   
Please print and complete fully. Mail together with $45.00 and the Registration Form.  

Program Title:  An Alternative Approach to Menopause Management and Hormonal Balance

Date (Today):  __________________

I. Learner's achievement of each objective was met. Yes ___ No ___

II. The instructor was:

Knowledgeable: No ____ Yes ____ Exceptional ____            

Well Prepared: No____ Yes____ Exceptional ____                 

Teaching Effectiveness (Scale 1 low -5 high) ______

III. The content was appropriate to the objectives:     

Yes______No______Exceptional______

The method utilized by the instructor was appropriate for teaching the content:

Yes___13___No______Exceptional_____

The opportunity to ask the instructor questions facilitated your understanding of the content:

Yes______No______Exceptional_____

IV. Overall rating of this program: Excellent________ Good________Poor________

V. What did you like most about this educational activity?

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VII. What would you do differently?
 

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VIII. Additional Comments

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Other optional questions which help us to plan future programs:

Age:____

Current position: (ex. staff nurse, faculty member, nurse practitioner etc)

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Current work environment: (ex. hospital, clinic, school, etc.)

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Highest level of education: (Check one)

High school _____

Diploma Program ____

Associate degree ____

Baccalaureate degree ____

Master's degree ____

Doctoral degree ____

Other topics of interest to consider for future programs:

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Signature_______________________________________

May we use your comments and name in promoting this program to other nurses?

Yes ____

No ____

Thanks so much!