Meeting Name:    Date:

1. Please rate your overall opinion of the meeting:
	Excellent   Good    Average    Poor     Very Poor
2. Please circle the appropriate number in response to the following statements:
		Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
	Registration process was simple:
	Advance materials were helpful
	Facilitators were well prepared
	Speakers help set the tone
	I felt as though I was an active participant
	This experience is relevant to our community
	Comments:
3. Please take a moment to provide any additional comments about the session, suggestions for future meetings, anything you would change and your interest in staying involved with this program:
	Name (optional):