Thank you for participating in the Small Rural Hospital Improvement Grant Program (SHIP) Technical Assistance (TA) call held on Thursday, January 24, 2013. Your feedback is important to us.

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* 1. The SHIP TA call increased my knowledge on the SHIP Grant Program.

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* 2. With the information provided in the SHIP TA call, I am able to communicate more effectively with my hospitals and partners on SHIP activities.

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* 3. How would you rate the overall effectiveness of our speaker, David Dietz?

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* 4. Overall, how satisfied are you with this SHIP TA call?

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* 5. I have follow-up questions on the SHIP Grant Program and would like to be contacted by SHIP TA staff for assistance. If so, please provide you name and contact information below.

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* 6. Other comments:

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