Participant Evaluation Form
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1Participant Evaluation Form
Directions: Complete the following evaluation at the end of the meeting. Circle the number at the right that
most closely approximates your feelings about each statement. Use the following scale:
5 = Strongly Agree
4 = Agree 3 =Neither Agree nor Disagree 2 = Disagree 1 = Strongly disagree
Strongly
Agree
Neither
Disagree
Strongly
agree
agree nor
disagree
disagree
The role of the Advisory Council
Was clearly articulated
5
4
3
2
1
Information was presented
5
4
3
2
1
in an organized, concise manner
Facilitator encouraged focused
discussion
5
4
3
2
1
Adequate opportunity to participate
and/or ask questions.
5
4
3
2
1
Breakout groups provided ample time
for discussion:
5
4
3
2
1
Central location, easy to reach
Yes_____
No_____
Do you require any special accommodations? : ________, if yes what__________________________________
Additional comments or questions: _______________________________________________________________________________________________
______________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
Name: __________________________________________________
(optional)
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