Eyemedica lecture feedback form

Feedback form
Please give us feedback on your overall experience at this lecture
The Event
What was the date of the event?
MonthDayYear
Date
What was the location of the event?
Which session did you attend?
Please select the first session you attended
How did you rate the quality of the lecture?

1 2 3 4 5
1 is Poor, 5 is Great
How did you rate the interaction?

1 2 3 4 5
1 is Poor, 5 is Great
Would you consider attending another lecture?*
Yes, definitelyMaybe, if the content was changedNo, never
Would you recommend a similar event to a friend?*
Yes, definitelyMaybe, if the content was changedNo, never
General comments
The Venue
Overall, were you satisfied with the venue and were you able to see and hear the presentations clearly?*
YesNo
What did you like about the venue
What did you dislike about the venue
Optional: Contact Details
Your Name
First NameLast Name
E-mail
Phone Number
Area CodePhone Number
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Eyemedica will use your information to contact you regarding CPD, news and other opportunities, please click agree if you would like to be contacted.
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Feedback form

The Event

The Venue

Optional: Contact Details