Form #2 Form #2 Group TA Evaluation

A HRQ Complex Patient Research

Group Technical Assistance Evaluation

Form Approved
OMB No. 0935-XXXX
Exp. Date XX/XX/20XX

[Webinar] Title:

[Webinar] Leader:

1. This [INSERT TYPE OF TA HERE, e.g., webinar]…

___ did not meet my expectations

___ met my expectations

___ exceeded my expectations

2. The leader(s) of this [webinar] had the knowledge and expertise to deliver the information in an effective manner.

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Completely Disagree					Completely Agree

2. I gained information and knowledge through my participation in this [webinar] that will be helpful in my research.

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Completely Disagree					Completely Agree

2. I am likely to make changes to my research (study design/ protocol/ implementation/ analysis/ results interpretation) because of information or knowledge I gained from this [webinar].

1	2	3	4	5	6	7	8	9	10
Completely Disagree					Completely Agree

Public reporting burden for this collection of information is estimated to average 5 minutes per response, the estimated time required to complete the survey. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.

2. Please tell us how this [webinar] could have been better/more useful:

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2. Other comments:

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