To better meet your individual needs and to plan future activities, please complete the following information. Forms may also be printed and faxed to (865) 576-9781.

Affiliation: (Select One)
County EMA State of Tennessee EMS DOE NNSA DOE/NNSA Contractor Fire Hospital/Medical 911 Coordination Law Enforcement Public Advisory Group Public Health Public Information Disaster Response Other

Instructions: Make a selection in the right-hand column that reflects your opinion of the following statements.
1. The Forum provided an opportunity to network with emergency management professionals.	Did Not Attend Disagree Neutral Agree
2. The Forum increased my knowledge of emergency management topics.	Did Not Attend Disagree Neutral Agree
3. Presentations were relevant to my needs.	Did Not Attend Disagree Neutral Agree
4. Seating was sufficient (sessions not too crowded).	Did Not Attend Disagree Neutral Agree
5. Indoor displays were accessible (Exhibit area not too crowded).	Did Not Attend Disagree Neutral Agree
6. Please provide feedback on any or all of the above statements.
7. Evaluate the breakout session topics. Make a selection in the right-hand column that reflects your opinion of the session topics.
Session 1
Changes in Information Sharing Since 9/11	Did Not Attend Not Okay Okay Good Great
The Fort Hood Active Shooter Event - Challenges in the Lessons	Did Not Attend Not Okay Okay Good Great
Medical Emergency Response at the Pentagon on September 11, 2001	Did Not Attend Not Okay Okay Good Great
Session 2
Seismic Hazard in the East Tennessee Seismic Zone	Did Not Attend Not Okay Okay Good Great
Oak Ridge Reservation Site Briefings	Did Not Attend Not Okay Okay Good Great
Social Media Impacts on Emergency Management	Did Not Attend Not Okay Okay Good Great
Session 3
A Report on the 2010 and 2011 Tennessee Natural Phenomena Events	Did Not Attend Not Okay Okay Good Great
U.S. Radiological Response to the 2011 Japan Earthquake	Did Not Attend Not Okay Okay Good Great
Citizens, The Sirens are Sounding. What Now?	Did Not Attend Not Okay Okay Good Great
8. Please provide feedback on any of the breakout sessions and/or the speakers identified above.
9. Please provide feedback on the indoor displays and/or the outdoor exhibits.
10. Please provide feedback on the Forum website.
11. What did you like best about the Forum? What did you like least about the Forum?
12. Please provide feedback on the Forum location. Easy to find? Parking okay?
13. Please provide feedback on the snacks and the supplies. What else would you like to see?
14. Please provide feedback on the lunch option, such as 'Was it convenient, affordable, and were the choices okay?'
15. What improvements would you recommend for future Forums?
16. Suggestions for future topics:
Record additional comments below: