Clinic Eval Form

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Clinic Eval Form

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Name of Clinic *

Clinicians Name *

Please rate the following upon completion of the clinic *

Strongly Agree

Somewhat Agree

N/A

Somewhat Disagree

Strongly Disagree

I have a thorough understanding of the subject matter

I felt encouraged to participate

I was able to ask questions and express ideas

The clinic was relevant to overall programming

The clinician maintained a safe environment.

The clinician gave clear explanations and was prepared.

The clinician displayed a thorough understanding of the subject matter.

This clinic contained content.

Strongly Agree

Somewhat Agree

N/A

Somewhat Disagree

Strongly Disagree

I have a thorough understanding of the subject matter

I felt encouraged to participate

I was able to ask questions and express ideas

The clinic was relevant to overall programming

The clinician maintained a safe environment.

The clinician gave clear explanations and was prepared.

The clinician displayed a thorough understanding of the subject matter.

This clinic contained content.

Explanations to any of the above statements (Optional).

Did you receive sufficient instruction on how to teach the specific population/apparatus with which you will be working? *

Yes

Unsure

Explanation to above question (Optional).

The information most valuable to you was: *

Topics that need more emphasis of should be included are:

Additional Comments

Volunteer name

Optional, but would allow us to reach out regarding any comments, if necessary

Submit

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