Course Survey Your Value your Opinion! Student Name (required) Student Email (required) Title: Doctor / Physical Therapist (required) Name of Course (required) Instructors Name (required) Date Course Was Taken Date Month Day Year JanFebMarAprMayJuneJulyAugSeptOctNovDec 12345678910111213141516171819202122232425262728293031 20162017 PLEASE RATE US ON A SCALE OF 1-5 WITH 5 INDICATING EXCELLENT AND 1 POOR SELECT THE NUMBER YOU FEEL MOST APPROPRIATE Course Offering Please Select The Appropriate Rating: 1. Course Content Met Your Needs: ---12345 2. Course Matched Description that was advertised: ---12345 3. Pace of the Class: ---12345 4. Textbook/Materials/Handouts: ---12345 5. Class Location & Equipment: ---12345 Comments? (Please elaborate) The Instructor Please Select The Appropriate Rating: 1. Knowledge of the Subject Matter: ---12345 2. Preparation for Each Class: ---12345 3. Communicated Material Effectively: ---12345 4. Responded Well to Student Questions: ---12345 5. Established Positive Rapport With Students: ---12345 Comments? (Please elaborate) Additional Questions What did you find was the most valuable part of this course? Do you have any suggestions on how we could improve this program? Other comments?