PARTICIPANT FEEDBACK FORM

Please enter your responses below.

Full Name

First NameMiddle NameLast NameSuffix

Title

Agency/Organizations/Department

Agency/Organizations/Department

Role

PlayerFacilitator/ControllerObserverEvaluator

PART I: RECOMMENDATIONS AND CORRECTIVE ACTIONS

1. Based on the exercise today the tasks identified, list the top three strengths and/or areas that need improvement.

Strengths

1:

2:

3:

Areas for Improvement

1:

2:

3:

2. Identify the action steps that should be taken to address the issues identified above. For each action step, indicate if it is a high, medium, or low priority.

	Corrective Action	Priority
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3. List the policies, plans, and procedures that should be reviewed, revised, or developed. Indicate the priority level for each.

	Item for Review	Priority
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PART II: ASSESSMENT OF EXERCISE DESIGN AND CONDUCT

Please rate, on a scale of 1 to 5, your overall assessment of the exercise relative to the statements provided below, with 1 indicating strong disagreement with the statement and 5 indicating strong agreement

The exercise was well structered and organized.

	1	2	3	4	5