CCML Professional Development Fund
Evaluation Form

Name:  ________________________________           Date: _________________

Telephone Number:     ___________________________________________________

E-Mail Address:    ______________________________________________________

Name of Instructor/Speaker:  
______________________________________________________________________

Brief Summary and Evaluation

Please provide a brief summary and evaluation of the course/program. 
Please include how the program met your expectations, if the content
was appropriate or useful, and whether speakers were well-pre pared.
Describe the idea or information most beneficial to you and/or your
colleagues.
______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Would you recommend this instructor/speaker to others? ___ Yes ___ No

If yes, would you recommend that CCML consider inviting this 
individual to speak at one of our programs?     _____ Yes    _____ No

If yes, please include any information you have about contacting this 
individual: 
______________________________________________________________________

______________________________________________________________________

Brief summaries from the evaluation forms may be considered for 
publication in Council Quotes.

Please return completed form to:

Deb Weaver     
weaver.debbie@tchden.org
Clinical and Instruction Librarian
Forbes Medical Library
The Children's Hospital
1056 E. 19th Ave. B180
Denver, CO  80218
Ph: 303-861-6219
Fax: 303-861-6786