Environmental Health Program Evaluation Form
Please provide your feedback and assessment to help us improve our Environmental Health Program.
Program Name
*
Date of Evaluation
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Your Name
First Name
Last Name
Your Role or Affiliation
*
Please Select
Program Participant
Staff Member
Community Member
External Evaluator
Other
Please rate the following aspects of the program:
*
Rows
Excellent
Good
Fair
Poor
Program Organization
1
2
3
4
Relevance of Content
5
6
7
8
Effectiveness of Activities
9
10
11
12
Knowledge of Presenters
13
14
15
16
Community Engagement
17
18
19
20
Overall, how satisfied are you with the Environmental Health Program?
*
1
2
3
4
5
What suggestions or comments do you have to improve the program?
Submit Evaluation
Should be Empty: