ALS2 Course - Candidate Evaluation

17% of survey complete.

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* 1. Name of Course Centre

	Course Centre
Course Centre	Course Centre Course Centre menu

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* 2. Day 1 of Course

Date

Date

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* 3. Day 2 of Course (or last day if modular/Recertification)

Date:

Date

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* 4. Professional Role

Doctor

Nurse

Paramedic

Other (please specify)

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* 5. Course Venue: State

ACT

NSW

NT

QLD

SA

TAS

VIC

WA

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* 6. Did you receive the following 4 weeks (or more) prior to the course :

	Yes	No
Confirmation of attendance	Confirmation of attendance Yes	Confirmation of attendance No
Manual	Manual Yes	Manual No
Pre-Course MCQ	Pre-Course MCQ Yes	Pre-Course MCQ No

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* 7. Where is your current residential address

ACT

NSW

NT

QLD

SA

TAS

VIC

WA

Other (please specify)