Customized TTA Consultant Feedback form

CUSTOMIZED TTA

OMB# 1121-XXXX
Date of Expiration: XXXX

Consultant Feedback

In order to help OVC TTAC better serve the field, we are reaching out to you and other consultants to obtain your feedback. We
will protect the privacy of your information in accordance with the Federal Privacy Act, and we will protect the confidentiality of
your responses using procedures we have in place. Only members of the Needs Assessment and Evaluation Team have access to
information that could identify respondents. Answers to these questions will only be reported after aggregating all responses, and
the results will never identify you as an individual. Other participants, presenters, OVC staff, OVC TTAC staff, and your employer
will not have access to what you as an individual say. Please note that completing this form is a requirement for serving as an
OVC TTAC consultant. If you have any questions about this survey or the evaluation, please contact [email protected].

EVENT: pre-printed information

SESSION: _ pre-printed information

LOCATION: pre-printed information

DATE(S): pre-printed formation

CONSULTANT(S): pre-printed information
OVC TTAC COORDINATOR: pre-printed information

Please indicate the extent to which you agree or disagree with the following statements. Mark “Not Observed” if you are unable
to assess the statement due to not being present or able to observe.
PLANNING AND DELIVERY
1. OVC TTAC was responsive to my questions and needs.
2. Discussions with OVC TTAC helped me to identify
critical issues and understand the needs of participants
prior to the session.
3. OVC TTAC provided me with the necessary information
and resources to help me adequately prepare for the
session.
4. The time allotment was adequate for the scope of
material covered.

Strongly
Disagree

Disagree

Neither
Agree nor
Disagree

Agree

Strongly
Agree

Not
Applicable

Not
Observed

1

2

3

4

5

NA

NO

1

2

3

4

5

NA

NO

1

2

3

4

5

NA

NO

1

2

3

4

5

NA

NO

□ Yes

□ No

5.

Would you recommend OVC TTAC to others?

6.

What could OVC TTAC have done differently to create a better session? (You may use the back of the form for more space.)

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7.

Do you have any other comments or suggestions? (You may use the back of the form for more space.)

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Thank you for taking the time to complete this form and helping to improve OVC TTAC activities.

Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control
number. The estimated average time to complete this form is 5 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the OVC TTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.