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Questions marked with an * are required Exit Survey
 
 
* Name of Observer: (last, first name)
   
 
 
 
* Pre-Shift Manager's Name: (last, first name)
   
 
 
 
* Date of Pre-Shift Observation:
   
 
 
 
* Time of Pre-Shift:
   
 
 
 
* Department Name:
   
 
 
 
* Timing: Did the pre-shift meeting begin promptly?
 
Yes
 
No
 
 
 
* Presentation: Presenter customized the pre-shift using his/her own words, not just reading, good flow of information, used eye contact, questions, role play, etc.
 
Yes
 
No
 
 
 
* Responsiveness: Presenter kept staff engaged, attentive and pre-shift was interactive.
 
Yes
 
No
 
 
 
* Q&A: Presenter actively invited questions and comments, fielded questions confidently, and offered to find out answers if not able to provide answers immediately.
 
Yes
 
No
 
 
 
* Role Model: Presenter was an example for the team, well-groomed and well-spoken.
 
Yes
 
No