Name: 

Using a scale of 1 (not effective) through 5 (highly effective), please answer, by filling in a number, the following questions:	Poor		Excellent
	1	2	3	4	5
1. The overall quality of the online training module was:
2. The appropriateness of the teaching strategy (web-based learning module) was:

3. The objectives of training module I are listed below. 
   1. Define and apply the methodology for doing cost analysis
   2. Demonstrate an ability to allocate costs into agreed upon cost centers
   3. Identify how to complete the time study
   4. State how to gather the data needed to complete the cost sheets

   Were the objectives met?  Yes No

4. The objectives of training module II are listed below. 
   1. Break down the relative value methodology for doing cost analysis
   2. Demonstrate an ability to complete forms 1-4 on the cost analysis
   3. Compare current fees to actual cost of providing service
   4. Choose fees based on the cost analysis and reimbursement principles

   Were the objectives met?         Yes No

5. The objectives of training module III are listed below. 
   1. Determine fees based on the cost analysis
   2. Interpret charges that will be recognized and paid by third parties
   3. Identify billing practices that increase the revenue stream for the agency
   4. Distinguish successful collection practices

   Were the objectives met?  Yes  No

6. Were the objectives related to the overall purpose/goal of activities?
    Yes No

7. List which module topic area(s) that were most valuable to you and why?
   1. 
   2.
   3.

8. In what ways do you plan to apply the information and/or skills gained from this online training?
   

9. Identify potential challenges you may have in using the ideas presented in the training module.
   

10. Please list ways to improve this module.
    

11. Did you feel that the workshop curriculum and presentation was sensitive to cultural, ethnic and racial issues?
    

12. How long did it take you to complete this activity?
     hours minutes

13. Please feel free to write any comments you might about about this training module.