O MB#: 1121-XXXX Requester Feedback
Date of Expiration: XXXX
In order to help OVC TTAC better serve the field, we are reaching out 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 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/users, consultants/presenters, OVC staff, OVC TTAC staff, and your employer will not have access to what you as an individual say. Your participation is in this survey is completely voluntary. If you have any questions about this survey or the evaluation, please contact [email protected]. NOTE: Please complete one form per requested session.
LOCATION: DATE(S):
CONSULTANT/PRESENTER(S):
OVC TTAC COORDINATOR:
Please indicate the extent to which you agree or disagree with the following statements.
PLANNING AND DELIVERY |
Strongly Disagree |
Disagree |
Neither Agree nor Disagree |
Agree |
Strongly Agree |
Not Applicable |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
|
|
1 |
2 |
3 |
4 |
5 |
NA |
Would you recommend OVC TTAC to others? □ Yes □ No
Would you recommend the consultant/presenter(s) to others? □ Yes □ No
Please explain why.
____________________________________________________________________________________
____________________________________________________________________________________
What aspects of the session were most helpful and why?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
What could be done differently to improve the session?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Do you have any other comments or suggestions?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
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 10 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.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Field, Michael |
File Modified | 0000-00-00 |
File Created | 2021-01-24 |