EVALUATION FORM

In order to improve the quality of our next program, we would appreciate receiving your feedback. 

Please feel free to make comments.  We thank you for your cooperation.

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* 1. On a scale of 1 (poor) to 5 (excellent), how well were you able to achieve the session objectives?

  1 2 3 4 5 N/A
A. Discuss the differences between Canadian integrated midwifery practice and U.S. “chaotic” practice, and how results follow director from differences in the two systems.
B. Explain how the structure and organization of the system can determine the results.

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* 2. On a scale of 1 (poor) to 5 (excellent), please rate the TEACHING EFFECTIVENESS of the presenter.

  1 2 3 4 5 N/A
Michael Klein, CM, MD, CCFP, FCFP, FAAP, FCPS, ABFP

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* 3. On a scale of 1 (poor) to 5 (excellent), please rate the effectiveness of the TEACHING METHODS used.

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* 4. On a scale of 1 (poor) to 5 (excellent), please rate how well was the PROGRAM MATERIAL ORGANIZED.

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* 5. On a scale of 1 (poor) to 5 (excellent), please rate the session OVERALL.

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* 6. What part of the program provided the most helpful information?

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* 7. What additional information would have been helpful?

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* 8. Additional comments

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* 9. Name (submit if applying for continuing education)

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* 10. Email (optional)

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