We appreciate your efforts!!! Don't forget -ONE Evaluation per group taught

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* 1. Enter the date. 

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* 2. Please name the county in which you are presenting the program.

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* 3. Check each program component that you taught to this group.

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* 4. After teaching the program, do you feel the written directions provided you:

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* 5. If "not enough" to which section(s) would you add information?

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* 6. Rate the entire Safe Medication - Safe Disposal Program (all 3 components)

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* 7. Overall, how would you rate (ONLY) the Safe Medication Disposal component?

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* 8. How would you describe the level of interest in the majority of participants?

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* 9. Please list the number of students in the session

# of Students: _______________       

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* 10. If you were to give yourself a grade for your teaching efforts, what grade would it be?

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