MLDP Host Site Agency Evaluation_Updated 5.3 (OMB)

Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

MLDP Host Site Agency Evaluation_Updated 5.3 (OMB)

OMB: 0990-0379

Document [docx]
Download: docx | pdf

OMH Minority Leadership Development Program (MLDP)

Host Site Agency Post Program Questionnaire


1. What date did the MLDP Fellow end their fellowship with the agency?  

2. Were you prepared for the MLDP Fellow from the beginning to the end of the program?  

  • Yes  

  • No  

  • Somewhat  

2a. If no, what was needed?  

3. Who supervised the MLDP Fellow and what is their position/title? (open-ended) 

4. What activities were MLDP Fellow assigned (mark all that apply)?  

  • Project(s) 

  • Research 

  • Program  

  • Manuscript Development  

  • Generating Reports  

  • Other:  

5. What was the MLDP Fellow’s public health area(s) of focus? (open-ended) 



6. Did the MLDP Fellow increase their leadership skills and/or overall public health knowledge.

6a. If yes, please explain: (open ended)

6b. If no, please explain which leadership skills needed improvement?

7.  Did the MLDP Fellow expand the agency portfolio?  

  • Yes  

  • No  

  • Maybe  

8.If yes, please explain: (open-ended)  







8. Was the OMH MLDP Fellowship of value to the agency?

  • Yes

  • No

  • Maybe

8a. If yes, please explain (open ended)

8b. If no, please explain. (open ended)

9. What changes or additions would benefit the agency in future OMH MLDP Fellowships? (open-ended)



10. Additional Thoughts? (Open-Ended) 



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorBrittny Bratcher-Rasmus
File Modified0000-00-00
File Created2024-11-30

© 2024 OMB.report | Privacy Policy