Conference Feedback and Evaluation Questionnaire -

Thank you for taking the time to attend our in-service regarding service recovery and empowering the front line staff presented by Jim Burrows. Your comments will enable us to better plan and execute future in-services and tailor them to meet your needs.

Sincerely,

Patient Satisfaction Committee

How did you attend this in-service?

In person

Web Ex

Other

Did the in-service fulfill your reason for attending?

Yes -- Absolutely

Yes -- But not to my full extent

No

What was the most beneficial aspect of the in-service?

Please indicate your overall satisfaction with this in-service

Was there information you were hoping to learn more about that was not covered?

What other topics related to patient satisfaction are of interest to you for another in-service?

Name

Title

Additional Comments

Thank you for taking the time to participate in this evaluation.