Healthcare Innovation Pilot Project Evaluation Form
Please provide your feedback on the healthcare innovation pilot project.
Evaluator's Full Name
First Name
Last Name
Evaluator's Email Address
example@example.com
Date of Evaluation
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Please rate the overall effectiveness of the pilot project.
1
2
3
4
5
Please rate the ease of use of the healthcare innovation solution.
1
2
3
4
5
Please rate the impact of the pilot project on patient care.
1
2
3
4
5
What were the key strengths of the pilot project?
What challenges or issues did you encounter during the pilot project?
Suggestions for improvement or future projects.
Submit
Should be Empty: