Teaching Learning Center Survey

1. Please enter the following information:

Please enter the following information: Last Name
First Name
Date
Time

2. Department Name:

Department Name:

3. Reason for visit?

Reason for visit?

4. Did you get the Help You needed?

Did you get the Help You needed? Yes

No

Need More Help

5. Are there any services that you would like in the future?

Are there any services that you would like in the future? What Services?

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