Program Implementation Survey Form
Please provide your feedback on the recent program implementation. Your insights will help us improve future rollouts.
Your Name
*
Organization Name
*
Implementation Phase
*
Planning
Initial Rollout
Full Implementation
Sustainment
How well does the program fit your organization’s needs?
*
Not at all
1
2
3
4
Extremely well
5
1 is Not at all, 5 is Extremely well
Please rate the adequacy of training and support provided.
*
Very poor
1
2
3
4
Excellent
5
1 is Very poor, 5 is Excellent
Please indicate your agreement with the following statements.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Resources were readily available
1
2
3
4
5
The implementation process was clear
6
7
8
9
10
The program objectives were achievable
11
12
13
14
15
What were the main challenges faced during implementation?
How would you rate the overall outcomes of the program so far?
*
Very Poor
Poor
Fair
Good
Excellent
Overall, how would you rate the program implementation?
*
1
2
3
4
5
Please provide any recommendations for future program rollouts.
Submit Feedback
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