The University of North Carolina at Chapel Hill
Gillings School of Global Public Health (link)

 Your guide to minority health-related activities
at UNC-CH and elsewhere 

13th Annual Summer Public Health Research
Institute and Videoconference on Minority Health

Site facilitator evaluation

If you prefer you may print this form and fax or mail the completed form - see fax number and address at bottom.

 1.   In what city and state/country was your viewing site located?
        City:   State (or country):

 2.   What is your site identification number

(The Site ID is in parentheses immediately after the name of your site at; the SiteID is usually the 9-digit postal code for the viewing location.)

 3.  What was the total number of participants at your site?       
 4.  Were your participants (check all that apply)
  Public health professionals (health educators, public health nurses, health administrators, . . .)
  Clinicians (i.e. doctors, nurses, physician assistants, social workers, . . .)
  Community Members
  Faculty, teachers, reseachers
  Students (undergraduate, graduate, doctoral)
  No participants - just taping
  1. Were there problems receiving the broadcast? Please indicate their nature (could not tune in the satellite, local weather conditions interfered, audio was noisy or disrupted, video was fuzzy or distorted, etc.)

  1. Were participants able to ask questions conveniently (check all available):

  by telephone? by fax? by e-mail?


  1. Was the time allocated for questions and comments:


too little

about right

too much

  1. Was the length of mid-session breaks:


too short

about right

too long


Please rate each of the following as



  1. Participants at my site seemed engaged during the broadcast
  1. Participants found the material interesting and important.
  1. Participants at my site felt able to ask questions.
  1. The web site was well-organized, convenient, and informative.
  1. Compared to others, this broadcast was well organized and well run.



  1. I will recommend this broadcast to other organizations.
  1. My organization would like to be a site for this broadcast in 2008.
  1. I would like to be a site facilitator for similar events in the future
  1. Overall, I think the Videoconference was time well spent.
17. Any comments about the speaker, topic, the web site, and anything else, including suggestions for future years?
  1. Please tell us your name   
    and email address 

Thank you very much for your interest in the
Summer Public Health Research Videoconference on Minority Health
and for taking the time to complete and return this evaluation form.

Back to the top

Minority Health Project| Department of Epidemiology
UNC Gillings School of Global Public Health
2104D McGavran-Greenberg, CB#7435 | Chapel Hill, NC 27599-7435
Phone 919-966-7436 | Fax 919-966-2089| E-mail

Last updated on: 4/16/2007 by Vic