PNCIMA Forum Webcast Feedback Form

Thank you for participating in the PNCIMA forum webcast. We appreciate you taking the time to share your experience with us so we can continue to improve into the future.

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* 1. Please rate this meeting.

	Very	Moderately	Slightly	Not at all
How informative did you find this meeting?	How informative did you find this meeting? Very	How informative did you find this meeting? Moderately	How informative did you find this meeting? Slightly	How informative did you find this meeting? Not at all
How interesting did you find this meeting?	How interesting did you find this meeting? Very	How interesting did you find this meeting? Moderately	How interesting did you find this meeting? Slightly	How interesting did you find this meeting? Not at all
How effective was the facilitator?	How effective was the facilitator? Very	How effective was the facilitator? Moderately	How effective was the facilitator? Slightly	How effective was the facilitator? Not at all

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* 2. Please rate this meeting.

	Plenty	A little	Not enough
How much opportunity did you have to express yourself?	How much opportunity did you have to express yourself? Plenty	How much opportunity did you have to express yourself? A little	How much opportunity did you have to express yourself? Not enough
How much did you learn about the PNCIMA process?	How much did you learn about the PNCIMA process? Plenty	How much did you learn about the PNCIMA process? A little	How much did you learn about the PNCIMA process? Not enough

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* 3. How was your experience attending via webcast?

	Excellent	Good	Average	Poor	N/A
Overall experience	Overall experience Excellent	Overall experience Good	Overall experience Average	Overall experience Poor	Overall experience N/A
Audio	Audio Excellent	Audio Good	Audio Average	Audio Poor	Audio N/A
Video	Video Excellent	Video Good	Video Average	Video Poor	Video N/A
Chat	Chat Excellent	Chat Good	Chat Average	Chat Poor	Chat N/A

Other (please specify)

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* 4. What was the most valuable part of the meeting for you?

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* 5. In your opinion, what was missing from this meeting?

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* 6. What relevant topics would you like to discuss in subsequent meetings?

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* 7. Other comments or questions about the PNCIMA process or the forums:

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* 8. How did you hear about this meeting?

Poster

Newspaper ad

PNCIMA newsletter

Word of mouth

Other (please specify)

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* 9. Information about you (optional)

Name:

Affiliation/organization

Address 1:

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City/Town:

Email Address:

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* 10. Would you like to sign up for the PNCIMA newsletter to get updates on progress and events?

Yes

I already am