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St. Paul Campus
Evaluate Your Teachers Form - St Paul Campus
Please complete the following evaluation. When complete, scroll down and click the submit button.

NOTE: * indicates a required field

About Yourself

Your Training Level*:

Evaluate The Director

 

Name

Rating
Director:
Comments on Director:

Evaluate The Chief Resident

 

Name

Rating
Chief Resident Name
Comments on Chief Resident:

Evaluate Children's Clinic Doctors (up to 3)
 

Name

Rating
Children's Clinic Doctor 1:
Children's Clinic Doctor 2:
Children's Clinic Doctor 3:
Comments on CHC Clinic Doctors:

Med/Peds Hospitalists (up to 3)

 

Name

Rating
Med/Peds Hospitalist 1:
Med/Peds Hospitalist 2:
Med/Peds Hospitalist 3:
Comments on Med/Peds Hospitalists:

PICU Doctors (up to 3)

 

Name

Rating
PICU Doctor 1:
PICU Doctor 2:
PICU Doctor 3:
Comments on PICU Doctor:

Evaluate Others (Community Doctors, Subspecialists, etc.)

 

Name

Rating
Name 1:
Name 2:
Name 3:
Comments on Others:

Teaching Nominations
Nomination for Teaching Award (Attending):
Nomination for Teaching Award (RN):
Date Last Modified: 09/13/2012 15:56