2026 CT HCC MRSE Participant Feedback Form

Exercise Participant Feedback Form

Thank you for participating in the February 2026 CT HCC Medical Response and Surge Exercise, Operation Ripple Surge. Your observations, comments, and input are greatly appreciated, and provide invaluable insight to better prepare our healthcare coalition members. All comments and personal information will remain confidential. Please keep comments concise, specific, and constructive.
Part I: General Information

Please enter your responses in the form field.
Are you requesting Continuing Education as and EMS Provider?*
Name (optional)

First NameLast Name
Agency/Organization Name:*
Please upload your organization sign in sheet. The sign in sheet (one per organization is required to document credit for participation.

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Please upload any additional notes or files that you utilized during the exercise.

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Part II: Exercise Design

Please rate, on a scale of 1 to 5, your overall assessment of the exercise relative to the statements provided, with 1 indicating strong disagreement, 2 indicating disagreement, 3 indicating neutral, 4 indicating agree, and 5 indicating strong agreement.
Pre-exercise briefings were informative and provided the necessary information for my role in the exercise.*

1

2

3

4

5

1 is Worst, 5 is Best
Exercise participants included the right people in terms of level and mix of disciplines.*

1

2

3

4

5

1 is Worst, 5 is Best
Participants were actively involved in the exercise. *

1

2

3

4

5

1 is Worst, 5 is Best
Exercise participation was appropriate for someone in my field with my level of experience/training.*

1

2

3

4

5

1 is Worst, 5 is Best
The exercise increased my understanding about and familiarity with the capabilities and resources of other participating organizations.*

1

2

3

4

5

1 is Worst, 5 is Best
The exercise provided the opportunity to address significant decisions in support of critical mission areas.*

1

2

3

4

5

1 is Worst, 5 is Best
After this exercise, I am better prepared to deal with capabilities and hazards addressed.*

1

2

3

4

5

1 is Worst, 5 is Best
Part III: Participant Feedback
STRENGTHS: I observed the following strengths associated during this exercise: Please select the appropriate exercise objective, provide an overview or analysis of the area for improvement and your recommendations for improvement. You must complete all three columns for each area of improvement you list.
Observed Strengths*
AREAS FOR IMPROVEMENT: I observed the following areas for improvement during this exercise.

1. Please list a Single Area for Improvement.

2. Please provide an analysis of why this is an area requiring improvement.

3. Please provide yoru recommendation for improvement.

4. Please select another area for improvement if you have additional items to add.
1. Area for Improvement #1*
2. Analysis*
3. Recommendation for Improvement*
4. Do you have an additional Area for Improvement?*
1. Area for Improvement #2*
2. Analysis*
3. Recommendation for Improvement*
4. Do you have an additional Area for Improvement?*
1. Area for Improvement #3*
2. Analysis*
3. Recommendation for Improvement*
4. Do you have an additional Area for Improvement?*
1. Area for Improvement #4*
2. Analysis*
3. Recommendation for Improvement*
Please provide any additional feedback you may have associated with this Exercise.*
Should be Empty:

Exercise Participant Feedback Form

Part I: General Information

Part II: Exercise Design

Part III: Participant Feedback