LIVE Evaluation Tracking Form

Use this form for your organization or coalition to track important evaluation information of your LIVE campaign events. Evaluation occurs throughout all phases of your event – planning, implementation and follow-up. Use this form as you plan and implement, and then during your group follow-up discussion. Once this is completed, you will have everything you need to apply for your LIVE Rewards (See Section VII). Use additional pages to record all the information requested on the form if need.

PLANNING PHASE:

  1. Type of event (See ‘Suggestions’ document in Section II of Toolkit)

  1. Purpose of event - Inspire? Inform? Persuade? Promote? Other (specify)

  1. Target audience:
Who do you want to show up?
Who do you want to participate?
Who do you want to inform through outreach (even if they don’t attend)?
  1. Organizations involved in planning, implementing, and supporting/funding the event

  1. Date of event

  1. What are the action steps you will give to the participants (things they can do)?

  1. How will you evaluate the event?

AT EVENT:

  1. Use a sign up sheet, or registration forms - include Name, Occupation, Contact Phone or E-mail

  1. Record the total number of participants (not counting the conveners)

  1. Use registration forms to determine the number of attendees in different groups – Consumers, HC professionals, policy-makers, legal professionals, community leaders, etc.

  1. Record what materials were distributed. (Which ones? How many of each?)

  1. Write a brief description of the event.

  1. Informal feedback (What were participants saying about the event?)

  1. Did you use the Participant Feedback Form? If yes, summarize the results.  Yes  No

AFTER THE EVENT:

  1. Gather informal feedback. Record the number of calls, e-mails, letters, etc. and summarize the comments. Keep copies for the files.

  1. Record your group impressions: Overall, how did it go? What worked well?What did not work well? What lessons were learned? How would you improve the event next time?

  1. Results/ Outcomes: What happened as a result of this event? Did it open up new opportunities? Did you gain new contacts/partners/members? Did the group receive invitations for additional presentations? Were donations or connections to funding made?

  1. Did you send out a Participant Feedback Form after the event?  Yes  No

Copyright 2005 by The National Hospice and Palliative Care Organization