Clinic Evaluation Form Clinic Evaluation Form If you have attended a clinic please complete a clinic evaluation form. This helps us improve our product and helps anchor the clinic content for you. Step 1 of 2 50% Date of Clinic* MM slash DD slash YYYY Clinic Leader Name*DisciplineAlpineSnowboardTelemarkAdaptiveNordicNon-Discipline SpecificWhat was the clinic topic? Level I Certification Prep Level II Certification Prep Level III Certifcation Topic of the Day (TOD) Specialty Clinic (Children, Freestyle, etc) What was the purpose of the clinic?*What was the desired outcome of the clinic?*What excercises or activities were used?*What were your takeaways from the clinic? Pease be specific.*Will this topic be useful in your role as an instructor? Yes No If you answered yes above, how? Clinician’s communication was clear, understandable, and succinct*(5) Great! Best Ever as usual!(4) Good, but not great(3) OK, pretty good(2) Needs improvement(1) Well below standards(0) Terrible. Why is this person a clinic leader?Technical or verbal content was balanced with ample practice time:*(5) Wow!(4) Good, but not great(3) OK, pretty good(2) Needs improvement(1) Well below standards(0) Terrible. Why is this person a clinic leader?I was given constructive, relevant, personal feedback:*(5) Great job!(4) Good, but not great(3) OK, pretty good(2) Needs improvement(1) I got no personal feedback(0) Terrible. Why is this person a clinic leader?Please supply any personal feedback and constructive comments so that we can improve this clinic in the future:Would you like us to follow up with you regarding your feedback or have your evaluation emailed to you? Yes, email me my summary or get back to me No, let's keep this confidential Your Name* First Last Your email* Δ
