Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Student Information First Name *Last Name *Email *Phone * Session Information Date of Systems Reset™: *Systems Health® Educator Peer Evaluator First Name: * Systems Health® Educator Peer Evaluator Last Name: * Systems Health® Educator Evaluator Email *Intern First Name Evaluated: *Intern Last Name Evaluated: *Intern Email being Evaluated: *Session Type *New studentFollow-upConsultationInternshipInstructions: This survey is designed for Systems Health® Educators to evaluate their colleagues' performance and professional practices. Please complete all sections based on your observations and professional interaction. Part 1: Administrative and Preparatory Skills How clearly does this Educator communicate preliminary agenda and instructions to student? *Very unclearUnclearNeutralClearVery clearPart 2: Student Rapport and Communication Skills How well does this Educator explain the Systems Reset? *Not at all wellSomewhat wellModerately wellVery wellExtremely wellPart 3: Systems Reset™ Session Management How appropriately does this Educator respond to student questions and concerns during the session? *Not at all appropriatelySomewhat appropriatelyModerately appropriatelyVery appropriatelyExtremely appropriatelyHow thoroughly does this Educator assess student lifestyle (diet, exercise, etc.)? *Not at all thoroughlySomewhat thoroughlyModerately thoroughlyVery thoroughlyExtremely thoroughlyHow well does this Educator tailor Systems Health® concepts to student? *Not at all wellSomewhat wellModerately wellVery wellExtremely wellPart 4: Personalized Plan and Student Education How clearly does this Educator explain student's' Natural Systems State? *Not at all clearlySomewhat clearlyModerately clearlyVery clearlyExtremely clearlyHow effectively does this Educator communicate student's' Current Systems State? *Not at all effectivelySomewhat effectivelyModerately effectivelyVery effectivelyExtremely effectivelyHow well does this Educator ensure the student understands the recommended next steps? *Not at all wellSomewhat wellModerately wellVery wellExtremely wellHow appropriately does this Educator assess and explain the student’s recommendations? *Not at all appropriatelySomewhat appropriatelyModerately appropriatelyVery appropriatelyExtremely appropriatelyPart 5: Overall Professional Assessment How would you rate this Educator's overall professional performance? *PoorFairGoodVery goodExcellentWould you recommend this Educator to friends? *Definitely notProbably notUnsureProbably yesDefinitely yesAdditional Comments Section Please share any other feedback about your experience:Thank you for completing this survey. Your feedback helps us provide better education for all students. Submit
