Phase III: PLU Evaluation Form

Full Name*

First NameLast Name

E-mail*

Phone Number*

Area CodePhone Number

Organization

Please rate the following PLU features:*

Rows	Excellent	Very Good	Good	Fair	Poor
Expanding my professional knowledge
The quality of practical applications
The layout/organization of the professional study

PLU*

Select the response that best reflects your level of agreement regarding your professional study experience.*

Rows	Strongly Agree	Agree	Disagree	Strongly Disagree
I had ample opportunities for reflection and dialog.
The content and knowledge sessions I attended were pertinent and useful in my practices.
I was equipped with ideas to implement or apply.
I made valuable professional contacts with whom I have communicated.

What elements of the PLU were of value to you?*

What elements of the PLU were not of value to you?*

What key pieces of information interested you the most?*

Which of the following actions have you taken or plan to take with the knowledge gained from this PLU? (select all that apply)*

Design a workshop for colleaguesShare information with colleaguesImplement changes in my workVisit CLAS website for more information about a topicResearch more about a topicOther

What is your overall professional study rating?*

How likely is it that you will earn future CLAS PLUs?*

How likely are you to recommend CLAS PLUs to a colleague?*

Additional thoughts: