Form 1 2018 OPP Mtg Assessment Form

OMB No. 0925-0648

Expiration date: 05/2021

National Institute of Mental Health

Outreach Partnership Program XXXX Annual Meeting Assessment

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Thank you for attending the NIMH Outreach Partnership Program annual meeting. Please take a moment to answer the following questions and rate how useful the presentations and discussions were to your organization and to your Outreach Partner efforts.

Use a  to indicate how useful the information presented is to your Outreach Partner activities.

Presentation	Very Useful	Useful	Somewhat Useful	Not Very Useful	Not Useful	Did not Attend
Presentation topic
Presentation topic
Presentation topic
Presentation topic
Presentation topic
Presentation topic

Please describe aspects of the presentations that were of most benefit and why:

_____________________________________________________________________________________________

Use a  to indicate your rating of the following statement about the meeting.

OVERALL	Strongly Agree	Agree	Somewhat Agree	Disagree	Strongly Disagree
I will be able to apply the information learned at this meeting in my outreach and education activities.

What kind of activities might you consider initiating, or expanding as a result of what you learned at this meeting?

Was the [meeting activity and/or interaction] useful in generating ideas for discussion and about ways to share meeting information at home?

Overall which aspects of the meeting were most helpful and why?

U se a  to indicate your rating of the following general statements about the meeting.

OVERALL	Excellent	Very Good	Good	Fair	Poor
Overall relevance of presentations and discussions as they relate to my work as an NIMH Outreach Partner or National Partner
Time allotted for presentations
Time allotted for discussion
Time allotted to learn about other Partners’ outreach and educational efforts
Meeting materials
Logistics support (travel, registration, and onsite)
Overall, I would rate this meeting

What topics would you like to hear about at future meetings?

What could be improved upon at future meetings?

I am a(n):

 Outreach Partner  Speaker or Guest  Federal Government Representative

 National Partner  NIMH or NIH Staff

Additional Comments: