• Day 3 Forms Upload, Evaluation & DN-1 Certificate

    Please note : The way you write your name, credentials, City, State etc.. in this form, the same way it will be printed on the certificate.
  • Format: (000) 000-0000.
  • Date (Please put the last date of the seminar)*
     - -

  • EVALUATION FORM

  • Name Of The Instructor :*
  • YOUR OVERALL SATISFACTION WITH THE COURSE (1 POOR, 5 EXCELLENT)?*
  • CURRENT LEVEL OF CONFIDENCE YOU NOW HAVE OF DRY NEEDLING (1 POOR, 5 EXCELLENT)?*
  • ABILITY YOU HAVE TO BEGIN INTRODUCING NEEDLING MONDAY (1 POOR, 5 EXCELLENT)?*
  • CONFIDENCE IN RECOMMENDING THIS COURSE TO OTHERS (1 POOR, 5 EXCELLENT)?*
  • THE INFORMATION RECEIVED WAS USEFUL AND BENEFICIAL*
  • THE PROGRAM MET THE STATED LEARNING OBJECTIVES*
  • THE PRESENTATION STYLE ENHANCED MY LEARNING EXPERIENCE*
  • THE PROGRAM FACULTY WAS RESPONSIVE TO QUESTIONS/COMMENTS*
  • THE EDUCATIONAL MATERIALS WERE USEFUL?*
  • THE LEARNING ASSESSMENT (TEST) WAS APPROPRIATE*
  • DO YOU FEEL THERE WAS COMMERCIAL BIASE OR INFLUENCE IN THIS ACTIVITY?*

  • PLEASE RATE THE FOLLOWING COMPONENTS OF THIS PROGRAM

  • REGISTRATION PROCESS*
  • PROGRAM FACULTY*
  • LOCATION*
  • WAS THE PROGRAM FACULTY KNOWLEDGEABLE REGARDING THE CONTENT OF THEIR PRESENTATION*
  • WAS THE PROGRAM FACULTY RELEVANT REGARDING THE CONTENT OF THEIR PRESENTATION*
  • WAS THE PROGRAM FACULTY EFFECTIVE WITH THE CONTENT OF THEIR PRESENTATION*
  • THE PRESENTATION MET MY EXPECTATIONS*
  • THE PROGRAM FACULTY STYLE WAS APPROPRIATE FOR THE MATERIAL PRESENTED*
  • THE PROGRAM FACULTY WAS RESPONSIVE TO QUESTIONS/COMMENTS*
  • THE PROGRAM MET MY OBJECTIVES*
  • THE INFORMATION RECEIVED WAS USEFUL AND BENEFICIAL*

  • UPLOAD ALL DAY 3 FORMS by taking a picture on phone:

    1. CHECKSHEET 
    2. TEST
    3. PICS/VIDEOS NOT YET UPLOADED
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