Name (as you would like it to appear on Certificate of Completion)
Credential (as you would like it to appear on Certificate of Completion, such as DC, CCN, RN, L.Ac.)
1. On a scale of 1-10 (10 being the best), how would you score your certainty and confidence on the materials/procedures covered today?
2. Do you have any questions or confusions from today? If yes, please explain.
3. On a scale of 1-10 (10 being the best), Please score the quality of the instructor.
4. On a scale of 1-10 (10 being the best), Please score the quality of the workshop administrator.
5. Do you have any suggestions or comments on the workshop in general?
6. Did the workshop meet your expectations? If no, please explain why.
7. Have you had any issues in this workshop that haven’t been resolved?
8. Please rate the following aspects of the workshop on a scale of 1-5 (5 = highest) and explain why the rating.
8A. Format: why that rating?
8B. Teaching methods: why that rating?
8C. Personal attention: why that rating?
8D. Overall value: why that rating?
8E. Instructor: why that rating?
9. Are there any changes or improvements you would like to see included in future workshops?
10. How did this workshop benefit you personally/professionally?
11. I would like more information about:
12. Is there anyone you'd like to refer to us to do this workshop? If so please give us their name, phone number and email.
13. Please tell us what wins, successes, accomplishments, or realizations you’ve had as a result of attending this workshop.
14. What would you tell other practitioners about why they should do this Workshop?
15. What made you decide to do the Nutrition Response Testing Workshop?
16. Would you like to open a Systemic Formulas account?
17. If yes, do you agree for UNS to share your contact data with Systemic Formulas?
18. I grant permission for Ulan Nutritional Systems, Inc. to use my name and/or comments from above for promotional purposes.