Name
*
First Name
Last Name
Email
*
Preferred Pronouns
Today's Date
MM
DD
YYYY
Class Date
MM
DD
YYYY
What about my teaching style worked well for you?
What about my teaching style was not helpful or did not work well for you?
Did you feel welcomed & included?
Yes
Somewhat
No
Did you feel the class was well balanced in the amount of time spent on teachings, question-and-answer time, and practice? If not, what would you have liked more of? Less of?
How well prepared did you feel I was in giving meditation instruction and guidance
Select Option
unprepared
somewhat unprepared
adequately prepared
very prepared
How well prepared did you feel I was in giving talks and teachings
Select Option
unprepared
somewhat prepared
adequately prepared
very prepared
How well prepared did you feel I was in answering questions
Select Option
unprepared
somewhat prepared
adequately prepared
very prepared
How well prepared did you feel I was in group facilitation
Select Option
unprepared
somewhat prepared
adequately prepared
very prepared
Were my meditation instructions and guidance clear, helpful, and easy to follow?
1 - unclear
2 - somewhat clear
3 - clear
4 - very clear
If not, what language or instructions were not clear?
[optional short response]
Were my talks clear, helpful, and easy to understand?
1- unclear
2 - somewhat clear
3 - clear
4 - very clear
Did you feel that my stories, examples, and supplementary materials were relevant to your background and life experience?
1 - not relevant
2 - somewhat relevant
3 - relevant
4 - very relevant
If not, what kinds of things would you like included?
Were my answers to student questions clear and helpful?
1 - unclear
2 - somewhat clear
3 - clear
4 - very clear
If not, can you provide examples of questions you feel that I did not handle well?
Did I seem present, connected, and responsive?
1 - unpresent
2 - somewhat present
3 - present
4 - very present
Is there anything else you’d like to share about your experience with me as a mindfulness teacher?
[optional short response]
Any further questions?
Please know I take all questions, thoughts, and concerns to heart. I will do my best to respond in a timely manner, though due to my schedule I sometimes need 7-10 days to respond with care.