| OUTPUT/OUTCOME EVALUATION FORMS (Evaluation Roadmap - Path 2)Customer
Satisfaction with Client Change
IMPORTANT (Instructions for customizing your form):
If you only have Acrobat Reader: Enter items directly onto
the form (within your web browser). Complete the entire form in
one session; then print. Any changes you make to the form will not
be saved.
If you have
Acrobat Standard or Acrobat Professional: You have two options.
You can follow the same procedure for Acrobat Reader or you have
the ability to save the file to your own computer and modify it
later; then print.
DO
NOT ALTER FORMS. Other than entering items, any alterations
will cause the forms to lose its scanning capabilities. When making
copies, make sure the four square cornerstones on the front and
back are clearly visible.
Retrospective Post (Level of Understanding) and Intentions to Adopt
Single letter sized sheet (front only); up to 10 customized
items for level of understanding; up to 7 customized items for intentions to adopt
Customer Satisfaction with
Retrospective Post (Level of Understanding)
Single legal sized sheet (front and back); up to 20 customized
items for level of understanding.
Customer
Satisfaction with Retrospective Post with Blank Space (Level of
Understanding)
Single legal sized sheet (front and back); up to 8 customized
items for frequency of behavior plus space for additional questions
of your own.
Customer
Satisfaction with Retrospective Post (Frequency of Behavior)
Single legal sized sheet (front and back); up to 20 customized
items for frequency of behavior.
Customer
Satisfaction with Retrospective Post with Blank Space (Frequency
of Behavior)
Single legal sized sheet (front and back); up to 8 customized
items for frequency of behavior plus space for additional questions
of your own.
Customer
Satisfaction with Intentions to Adopt
Single legal sized sheet (front and back); up to 15 customized
items for intentions to adopt.
Customer
Satisfaction with Retrospective Post (Level of Understanding) and
Intensions to Adopt (short version)
Single legal sized sheet (front and back); up to 10 customized
items for level of understanding; up to 7 customized items for intentions
to adopt
Customer
Satisfaction with Retrospective Post (Level of Understanding) and
Intentions to Adopt (long version)
2 letter sized sheets (front and back); up to 26 customized items
for level of understanding; up to 20 customized items for intentions
to adopt. DO NOT staple on the black, square, cornerstones.
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