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* 1. Please tell us your first and last name:

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* 2. CHES/MCHES number:

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* 3. Please rate how well the following learning objective was met: "To learn about the evidence-based strategies used by the National Center on Disability in Public Health, including four key factors of capacity building and two key factors of capacity that support inclusion of people who have a disability in public health.."

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* 4. Please rate how well the following learning objective was met: "To examine key areas of health disparity among people who have a disability."

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* 5. Please rate how well the following learning objective was met: "To describe applications of a Community of Practice to facilitate inclusion of people who have a disability in health promotion efforts."

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* 6. Please rate the degree to which the session met your learning needs.

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* 7. Please rate the overall quality of this session.

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* 8. Please rate the speaker in the following areas:

  Very poor Poor Fair Good  Excellent
Knowledge of Subject Matter
Organization/ Clarity of Presentation
Useful Information
Speaker/Participant Interaction
Use of Allotted Time
Audio/Visual Aids
Handouts

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* 9. Please provide any additional comments in this space.

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