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Children's Western Event Survey

1. Children's Western Event Survey

Please complete the Survey below so that we can make our Western events the most educational and fun for you.

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* 1. Event Information

What Event Did you Attend?

What was the Name of your Clinician?

What was the Date and Location of the Event?

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* 2. Please Give your Feedback for your Clinician's Overall Performance running the event.

	Did Not Meet	Met Some, Not All	Met	Met All and Exceeded Some	Exceeded All
Clinician Communication Skills:	Clinician Communication Skills: Did Not Meet	Clinician Communication Skills: Met Some, Not All	Clinician Communication Skills: Met	Clinician Communication Skills: Met All and Exceeded Some	Clinician Communication Skills: Exceeded All
Clinician Feedback Skills:	Clinician Feedback Skills: Did Not Meet	Clinician Feedback Skills: Met Some, Not All	Clinician Feedback Skills: Met	Clinician Feedback Skills: Met All and Exceeded Some	Clinician Feedback Skills: Exceeded All
Clinician's Ability to Lead the Group Effectively:	Clinician's Ability to Lead the Group Effectively: Did Not Meet	Clinician's Ability to Lead the Group Effectively: Met Some, Not All	Clinician's Ability to Lead the Group Effectively: Met	Clinician's Ability to Lead the Group Effectively: Met All and Exceeded Some	Clinician's Ability to Lead the Group Effectively: Exceeded All
Clinician's Ability to Respond to the Goals of the Group Effectively:	Clinician's Ability to Respond to the Goals of the Group Effectively: Did Not Meet	Clinician's Ability to Respond to the Goals of the Group Effectively: Met Some, Not All	Clinician's Ability to Respond to the Goals of the Group Effectively: Met	Clinician's Ability to Respond to the Goals of the Group Effectively: Met All and Exceeded Some	Clinician's Ability to Respond to the Goals of the Group Effectively: Exceeded All
Clinician's Safety Awareness:	Clinician's Safety Awareness: Did Not Meet	Clinician's Safety Awareness: Met Some, Not All	Clinician's Safety Awareness: Met	Clinician's Safety Awareness: Met All and Exceeded Some	Clinician's Safety Awareness: Exceeded All
Clinician's Ability to Make it Enjoyable and Educational:	Clinician's Ability to Make it Enjoyable and Educational: Did Not Meet	Clinician's Ability to Make it Enjoyable and Educational: Met Some, Not All	Clinician's Ability to Make it Enjoyable and Educational: Met	Clinician's Ability to Make it Enjoyable and Educational: Met All and Exceeded Some	Clinician's Ability to Make it Enjoyable and Educational: Exceeded All
Clinician's Ability to Demonstrate the Tasks and Maneuvers Effectively:	Clinician's Ability to Demonstrate the Tasks and Maneuvers Effectively: Did Not Meet	Clinician's Ability to Demonstrate the Tasks and Maneuvers Effectively: Met Some, Not All	Clinician's Ability to Demonstrate the Tasks and Maneuvers Effectively: Met	Clinician's Ability to Demonstrate the Tasks and Maneuvers Effectively: Met All and Exceeded Some	Clinician's Ability to Demonstrate the Tasks and Maneuvers Effectively: Exceeded All

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* 3. What Would Encourage You to Attend More Educational Events?