B All Grantee Meeting Individual Session Feeback

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

Attachment B - All Grantee Meeting Individual Session Feedback Form

Maternal, Infant, and Early Childhood Home Visiting Program All Grantee Meeting Feedback Forms

OMB: 0915-0212

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OMB Control No. 0915-0212

Expiration Date: 07/31/2021

2019 MIECHV All Grantee Meeting - Individual Session Feedback Form

February 26 – 28, 2019


Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 0915-0212. Public reporting burden for this collection of information is estimated to average .03 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 18N136B, Rockville, Maryland, 20857.



Shape1 Please select your affiliation



MIECHV State Region or Territory

Tribal Home Visiting Program

Other


Please select the role that most closely aligns with your responsibilities related to the MIECHV project.


Grantee Lead/Director/Coordinator

Grantee Data/Evaluation Staff

Grantee Program Staff/Consultant

Grantee Grants Management/Fiscal Staff

Home Visitor

ECCS Coordinator/Staff

Federal Staff/Partner

Model Developer

National TA Provider

Speaker

Other


Shape24

Please rate each session using the scale listed below


Not at all

Somewhat

Very much

Very little

Quite a bit


Shape30


Please indicate the degree (enter rating 1, 2, 3, 4 or 5 in the box) to which the Plenary or Breakout session...


Achieved intended objectives

Met your needs

Provided new information

Allotted time for questions and and/or quality discussion

Was well organized, engaging and effectively presented

Speaker(s) demonstrated topic expertise

Provided information you can apply to practice and/or enhanced your professional expertise

Plenary: Date, title and presenter

Breakout Session: Date, title & presenter


What is one thing that you like best about the session:


What is one thing that you would change:


Other comments:

Shape48


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorRashelle Lee
File Modified0000-00-00
File Created2021-01-13

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