MemorialCare Cancer Institute Class Evaluation Form

Class title:

The following questions will help us better understand the needs of our community. We need and appreciate your honest feedback.

How would you rate your overall satisfaction with the presentation?

Very Unsatisfied

Unsatisfied

Neutral

Satisfied

Very Satisfied

Did you learn something new at today’s class?

Yes

If yes, let us know one thing that you learned.

Did the content of the presentation meet your expectations? If not, what would you have liked to see?*

If yes, let us know one change you plan to make.

What other topics or programs are you interested in?

How did you hear about this program?

Senior Plus newsletter

Care Connection magazine

memorialcare.org

Physician office

Medical group calendar

Other

If you selected "other", please let us know where you heard about the program below.

If you’d like more information about our classes, events and services, please type your full name, as well as email and/or mailing address in the space below.

*MemorialCare Cancer Institute and our physician group partners encourage ongoing community health education and periodically send updates on future programs in a confidential manner. MemorialCare Cancer Institute and our physician group partners do not provide or sell program attendee contact information to outside entities.