Question Title

* 1. How satisfied are you with  the following aspects of our services?

1. Knowledge demonstrated by staff

Question Title

* 2. Responsiveness of staff to your needs

Question Title

* 3. Usefulness of Information/assistance provided

Question Title

* 4. Overall quality of the services provided

Question Title

* 5. How can we improve our service delivery to you?.

Question Title

* 6. What topic or skill area was addressed by the training and/or technical assistance we provided? (i.e. diabete management, quality improvement, EMR, OSZV, PCMH)

Question Title

* 7. To what degree to you feel you have improved your knowledge or skills as a result of your work with us? Complete one line for each topic or skill area addressed by the training and/or technical assistance provided. (i.e. diabetes
management, quality improvement, EMR, OSV, PCMH)

  No Improvement Minimal Improvement Moderate Improvement Large Improvement Not Sure
Diabetes Management
Quality Improvement
EMR
OSV
PCMH

Question Title

* 8. To what degree do you feel your organization has improved your knowledge or skills as a result of your work with us? Complete one line for each topic or skill area addressed by the training and/or technical assistance provided. (i.e. diabetes management, quality improvement, EMR, OSV, PCMH)

  No Improvement Minimal Improvement Moderate Improvement Large Improvement Not Sure
Diabetes Management
Quality Improvement
EMR
OSV
PCMH

Question Title

* 9. To what degree do you feel your organization has improved its capacity in the following areas as a result of your work with us? Complete one line for each topic or skill area addressed by the training and/or technical assistance provided. (i.e. diabetes management, quality improvement, EMR, OSV, PCMH)

  No Improvement Minimal Improvement Moderate Improvement Large Improvement Not Sure
Diabetes Management
Quality Improvement
EMR
OSV
PCMH

Question Title

* 10. What do you feel is the most valuable result of your work with us?

Question Title

* 11. What additional technical assistance or trainings do you think would help or enhance your organization right now?

Question Title

* 12. Please provide any other comments, questions or concerns.

T