Global Disease Prevention Program Evaluation Form
Please provide your feedback to help us assess and improve our global disease prevention initiatives.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Country of Residence
*
Please Select
United States
United Kingdom
India
Nigeria
Brazil
China
South Africa
Other
Your Role in the Program
*
Please Select
Program Participant
Healthcare Worker
Community Leader
Volunteer
Program Organizer
Other
Which disease prevention program did you participate in?
*
Please rate the following aspects of the program:
*
Rows
Excellent
Good
Average
Poor
Program Content
1
2
3
4
Facilitator's Knowledge
5
6
7
8
Usefulness of Materials
9
10
11
12
Relevance to Local Needs
13
14
15
16
How would you rate your knowledge of disease prevention after the program?
*
1
2
3
4
5
What impact do you believe the program will have on disease prevention in your community?
*
Significant positive impact
Some positive impact
Little or no impact
Negative impact
Not sure
Were the resources and materials provided sufficient for effective learning?
*
Yes, fully sufficient
Somewhat sufficient
Not sufficient
Overall, how satisfied are you with the program?
*
Not satisfied
1
2
3
4
Very satisfied
5
1 is Not satisfied, 5 is Very satisfied
Please share any suggestions for improvement or additional comments.
Submit Evaluation
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