Feedback Form

Please complete the following survey so that we may obtain your opinion, criticisms and suggestions for improvements with reference to the event you are currently.


Course Name:
Course Date:
Select a date from the calendar.
Faculty:
Candidate Name:
Mobile:
Specialty:
Country:
Hospital Address:
Telephone:
Email Address:  
Please state your position in the hospital:
Please state the number of years you have been in practice:
Please state the number of cases you perform by yourself per year:


How would you grade this event:



The Health Economic session was relevant & informative (if applicable):



There was enough time to interact with colleagues:



The content was educational enough to help me to improve my practice:



The presentation was engaging and comprehensive:



Overall, I was satisfied with this event:



Do you have any additional comments on quality of the whole event:
Faculty Speaker
Teaching skills:


Ability to teach a reproducible technique:


Ability to discuss how to avoid complications & answer all questions:


Honest on his own experience:


Ability to build a clinical program:


Know–how to easily approach the participants:


Ready to answer all questions and enter into discussion and debate with participants:


Please grade the following. The products I was trained on meets my needs:



I find a place/procedure where I can apply the products in my practice:



How would you rate the demo session (if applicable):


What values do you see this course is adding to your practice:
Do you believe you require further information before trying these techniques:



What type of additional information would you need:
Hotel Accommodation (if applicable):



Group Dinner (if applicable):



SSI Staff:



What is ONE KEY LEARNING you have taken away from this event:
SSI would like to further contact you, in regard to new professional education possibilities that we can offer you:
If you wish to be in the database, please add you e-mail address/s: