Tiered Evaluation Request

Tiered Evaluation Request

Course Number and Name*

Please enter your elective course number and name.

Requestor Name*

Requestor Email*

Configuration Options*

Automated: Known faculty that will work with all students. Student Identify Supervisor: Group of faculty or residents that may work with students. Students need to identify who they worked with.

Select

Course Faculty*

Please provide the name and email for course faculty that will evaluate students.

Student Evaluation of Course Faculty

Please check the box below if you would like students to evaluate course faculty.

Residents and Fellows

Will residents or fellows be evaluating students?

Select

Student Evaluation of Residents and Fellows

Please check the box below if you would like students to evaluate residents/fellows.

Residency Programs

Please provide the name of the residency or fellowship programs that are associated with the course.

Number of Required Evaluators*

Enter the required number of evaluators (0-10) for students to select. Students will receive reminders until the required number has been met.

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