THR Leadership University Customer Request Form

Exit Survey »

Hello:
Thank you for utilizing the Center for Learning to help support your needs. Please fill out the following form to enable us to identify some of your major concerns.

Thank you very much for your time and support. Please begin by clicking on the Continue button below.

* First Name :
* Last Name :
* Phone :
* Email Address :

In what THR facility are you currently employed?

What prompted this request? What is the presenting problem?

What are the desired outcomes you want to achieve? In other words, in a perfect scenario what would success look like?

Who will be the audience? (Please choose from the best solution below)

What have you tried so far to address the situation/challenge?

When would you like to begin?

Do you see any barriers to accomplish the desired outcome?

What will success look like?

How many people will be impacted?

What will be the impact to your department/business unit if change/improvement does not occur?

Overall comments: