Evaluation Form

Your input in the pilot test of this module is invaluable.  Please complete this evaluation so that we can improve the experience for students in the future.  

Please select the answer that best matches your experience with this module.

1. The goal and objectives of the module matched the content in the module. Select Below 1.) Strongly Disagree 2.) Disagree 3.) Unsure 4.) Agree 5.) Strongly Agree

2. I feel that counseling individuals about folic acid is important. Select Below 1.) Strongly Disagree 2.) Disagree 3.) Unsure 4.) Agree 5.) Strongly Agree

3. I would recommend this course to a fellow student or colleague. Select Below 1.) Strongly Disagree 2.) Disagree 3.) Unsure 4.) Agree 5.) Strongly Agree

4. The information presented in the module is consistent with the information on folic acid and neural tube defects that I have seen in the past. Select Below 1.) Strongly Disagree 2.) Disagree 3.) Unsure 4.) Agree 5.) Strongly Agree

5. The module provided convincing evidence that counseling individuals about folic acid is important.  Select Below 1.) Strongly Disagree 2.) Disagree 3.) Unsure 4.) Agree 5.) Strongly Agree

6.  The "For Your Profession..." section provided relevant information and examples that I am able to apply to my work. Select Below 1.) Strongly Disagree 2.) Disagree 3.) Unsure 4.) Agree 5.) Strongly Agree

7.  I am more confident in my ability to counsel individuals about folic acid than I was before taking the module.  Select Below 1.) Strongly Disagree 2.) Disagree 3.) Unsure 4.) Agree 5.) Strongly Agree

8. Please share any technical difficulties you may have encountered while completing the module (i.e. signing-in, icons, navigation, hyperlink, pop-up windows etc):

9.  Any additional comments: 
 

Thank you for completing the evaluation!  We appreciate your patience in completing this form.

Send comments/questions to: folicacid@asph.org