Health Fair Evaluation Form

Use this form to report on the results of FA's participation in a health fair event.

Event Name: ________________________________

Location: ________________________________

Date/Time: ________________________________

Est. Number of trifolds given out:  ________________________________

Other materials given out:  ________________________________

Projected attendance:  ________________________________

Actual attendance:  ________________________________

Parking expenses:  ________________________________

Cost of booth or table:  ________________________________

Approximate # of actual connections made:  ________________________________

What worked well?  ________________________________

What did not work? ________________________________

What could be changed or done differently? ________________________________

Was this an effective outreach venue? Y or N

Were we well-received? Y or N

Did the event host group provide all needed info? (directions, parking passes, etc) Y or N

Was lunch coverage manageable? Y or N

Did the Health Fair Kit facilitate this event? Y or N

Reporting Member Name ________________________________

Telephone:

Home ________________________________

Cell ________________________________

Email address ________________________________

Email Completed Form as soon after the event as possible to:

WAIPI@foodaddicts.org, EAIPI@foodaddicts.org , or MEPI@foodaddicts.org