Date the survey was complete
*
-
Month
-
Day
Year
Date
Date the course was completed
Name
*
First Name
Last Name
Email
*
example@example.com
Practice Name
*
Practice Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is Your Role in the Practice?
*
Dentist
Assistant
Lab Technician
Other
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Please answer the following questions based on your course experience:
1. The MOD Institute facility was adequate in size, comfortable and convenient.
*
1. Strongly disagree
2. Disagree
3. Neutral
4. Agree
5. Strongly Agree
2. Course administration was organized and polite.
*
1. Strongly disagree
2. Disagree
3. Neutral
4. Agree
5. Strongly Agree
3. Course objectives were consistent with promotional material
*
1. Strongly disagree
2. Disagree
3. Neutral
4. Agree
5. Strongly Agree
4. Course material was current, logically organized, and presented in adequate depth.
*
1. Strongly disagree
2. Disagree
3. Neutral
4. Agree
5. Strongly Agree
5. The instructor demonstrated complete grasp of the material presented.
*
1. Strongly disagree
2. Disagree
3. Neutral
4. Agree
5. Strongly Agree
6. The instructor was approachable and enthusiastic about the subject.
*
1. Strongly disagree
2. Disagree
3. Neutral
4. Agree
5. Strongly Agree
7. Audio + visual materials were an added value to the course.
*
1. Strongly disagree
2. Disagree
3. Neutral
4. Agree
5. Strongly Agree
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8. The hands on activities served to reinforce lecture and provided adequate time to practice the concepts taught.
*
1. Strongly disagree
2. Disagree
3. Neutral
4. Agree
5. Strongly Agree
9. Overall, this course met my expectations.
*
1. Strongly disagree
2. Disagree
3. Neutral
4. Agree
5. Strongly Agree
10. Overall, I would rate this course...
*
1. Very poor
2. Poor
3. Neutral
4. Good
5. Perfect
11. Overall, I would rate this instructor...
*
1. Very poor
2. Poor
3. Neutral
4. Good
5. Perfect
12. The instructor was both approachable and enthusiastic about the subject.
*
13. What was your least favorite portion of the course programming?
*
15. Do you have any suggestions for improvement?
Submit
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