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Appendix F: Planning Group Epidemiologic Profile Feedback Form
The purpose of this form is to provide the writers of HIV/AIDS epidemiologic
profiles feedback from their end users regarding the ease of use and
applicability of the profile to prevention and care planning activities.
Please complete this feedback form and send it to the writer or lead writer of
your HIV/AIDS epidemiologic profile.
What is your role on the planning group?
_______________________________________
Did planning group members have a role in creating the epidemiologic
profile?
__Yes __No
If yes, explain the role.
_______________________________________
_______________________________________
_______________________________________
_______________________________________
Was the epidemiologic profile easy to read?
__Yes __No __Somewhat
How were the findings of the epidemiologic profile communicated to you?
__Print copy only
__Profile writers presented epidemiologic profile to planning group
__Other type of presentation
_______________________________________
_______________________________________
Were the findings of the epidemiologic profile clear to you?
__Yes __No __Somewhat
If not, explain why.
_______________________________________
_______________________________________
_______________________________________
_______________________________________
Was the epidemiologic profile useful to your planning process?
__Yes __No __Somewhat
If not, explain why.
_______________________________________
_______________________________________
_______________________________________
_______________________________________
Describe how you used the epidemiologic profile in your planning
activities.
How can next year’s profile be improved?
_______________________________________
_______________________________________
_______________________________________
_______________________________________
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