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KY MMIS Project<br />
Provider Evaluation – Provider Workshop<br />
Date:<br />
Thank you for attending this session. We’d appreciate your feedback, as well as suggestions on how we can<br />
improve future sessions.<br />
Please answer the following questions, rating them on a scale of 1-5, with 1 being strongly disagree and 5 being<br />
strongly agree.<br />
Strongly<br />
Disagree<br />
Somewhat<br />
Agree<br />
Strongly<br />
Agree<br />
Question 1 2 3 4 5<br />
1. Material was appropriate for the audience.<br />
Comments:<br />
2. Presentation was well-organized and easy to follow.<br />
Comments:<br />
3. Session leader was easy to hear/understand.<br />
Comments:<br />
4. The Session leader was well-versed in their subject area and presented information<br />
in a clear, understandable manner.<br />
Comments:<br />
5. I was given appropriate material/handouts.<br />
Comments:<br />
6. Questions were answered to my satisfaction.<br />
Comments:<br />
7. I was able to see/hear the audiovisual portion with no trouble.<br />
Comments:<br />
If you would like to receive information via e-mail, please provide address below.<br />
Comments:<br />
Optional: if you would like a member of the KY MMIS team to contact you, please provide your contact information below.<br />
Name: Department/Branch:<br />
Phone Number: Email:
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