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Contact EURACT
E-mail
Phone
(32) 16 33 74 64
FAX
(32) 16 33 74 80
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Evaluation After the successful completion of an exchange visit this evaluation
form has to be completed. The evaluations will be the basis for an annual
report to the WONCA/EURACT-council on the progress of the programme
as well as documentation for the later application for EU-funding.
EVALUATION FORM - TRAINEE
| Name: |
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Host Practice: |
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| Address: |
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Address: |
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| Dates for Exchange Study Visit: |
| How did you hear about the "Hippokrates"-programme? |
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| How did you organize your Exchange Study
Visit? |
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| How did you finance your Exchange Study
Visit? |
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| Did you have any difficulties in the preparation
of your Exchange Study Visit? |
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| What did you learn from your Exchange
Study Visit? |
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EVALUATION FORM - TRAINEE
| Name: |
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| What was especially good/successful? |
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| What could have been better? |
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| Do you find your participation in the "Hippokrates"-programme
as being impor-tant for your professional formation, and if so, how? |
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| On a scale from 0(worst) to 10(best) how do you rate your Exchange
Study Visit as a whole? |
| Rating: |
| Do you plan to promote the "Hippokrates"-programme among
your colleagues, and if so, how? |
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| Further comments, suggestions (if necessary please continue overleaf) |
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Please send to:
WONCA Region Europe, EURACT Secretariat
General Practice Dept., Catholic University of Leuven
Kapucijnenvoer 33, Blok J, B-3000 Leuven, Belgium
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