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Client Agency *

TA Number *

Consultant(s) who provided service *
Evaluation completed by *

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1. How helpful was the consultant’s information? *
  no help almost no help of limited help moderately helpful very helpful

2. Please indicate how the information/assistance was helpful or if it was not helpful, why? *

3. Please tell us how the technical assistance was helpful in building the capacity of your organization? *

4. If you have not found the information helpful yet, do you think it will in the future? *
  Yes No Not Applicable

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Please rate the consultation using a scale of 1 to 5 (1 being least and 5 being most). Check only ONE.

1. (Contractor Name) arranged for the delivery of consulting services in a timely and adequate manner. *

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5

2. The consultant appeared competent in his/her field and brought the necessary background and experience for dealing with the designated problem area.*

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5

3. The consultant dealt fully and adequately with the specific areas of requested assistance . *

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5

4. The consultant’s recommendations were timely, practical and addressed our needs. *

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5

5. How would you rate the responsiveness of Contractor’s consultants and staff in meeting your consultant needs? *

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4

5

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Does your organization require additional assistance at this time? *
  Yes No

Please include any additional comments or suggestions for improvement.

Thank you for your feedback! If you have any questions or future technical assistance needs, please contact us:

Contractor: LGBT TRISTAR
Address: PO BOX 411, San Francisco, CA 94104
Contact Person: Gil Gerald
Telephone Number: 415-627-9143
FAX Number: 415-627-9153
Email: gilgerald@lgbt-tristar.com