Evaluation and Surveillance System Assessment Form
Assess the evaluation and surveillance system by sharing system details, scoring key capabilities, and noting observations and improvement needs. Use the same exact title throughout the form.
System Overview
System Name
*
System Type / Purpose
*
Please Select
Evaluation System
Surveillance System
Hybrid Evaluation and Surveillance System
Other
Organization / Department
*
Primary User Group
Location / Coverage Area
Assessment Scoring
Assessment Criteria
*
Rows
1 - Strongly Disagree
2 - Disagree
3 - Neutral
4 - Agree
5 - Strongly Agree
Functionality
1
2
3
4
5
Data Accuracy
6
7
8
9
10
Timeliness
11
12
13
14
15
Usability
16
17
18
19
20
Reporting
21
22
23
24
25
Integration Readiness
26
27
28
29
30
Overall System Rating
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Observations and Needs
Observations / Comments
*
Recommendations / Improvements
*
Submit
Should be Empty: