Program Evaluation Consent Form

Obtain informed consent from evaluation participants while also capturing their assessment of the program: effectiveness, strengths and areas for improvement. Date-stamped and ready to file.

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Full name

Nombre

Apellido

Email address

Date

On a scale of 1-10, how would you rate the overall effectiveness of the program?

Not likely

1 2 3 4 5 6 7 8 9 10

Very likely

What specific aspects of the program did you find most beneficial?

In what areas do you feel the program could be improved?

How likely are you to recommend this program to others?

Very likely Likely Neutral Unlikely Very unlikely

Do you have any additional comments or suggestions for improving the program?

Anything to add?

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