Feedback System for Chairs

Request Form

Please complete the form below. Multiple chairs can be included in one request if surveys will be administered using the same start and end dates. If different dates are needed, please submit a separate request for each set of dates.

The primary contact will receive an email when the surveys are set up. Please contact The IDEA Center with questions (800-255-2757 or

You will need to complete and submit this request at one time. For more information about the IDEA Feedback System for Chairs, please refer to our website.

Step 1 - When will the surveys be administered?

Step 2 - Who is the primary contact for these surveys?

Step 3 - Who should we contact for billing?

Step 4 - Which Department Chair(s)?

On each line in this section, enter the Department Chair's Name, Title, and Email. Then add Raters, and Additional Questions (optional). Click the "Add Another" button to add more chairs to the request.

TIP Place your mouse cursor over any of the table headers to see additional help text.

Name Job title and unit Email Rater Emails Additional Questions
Full name required! Required! Required! Invalid email!

Insufficient raters: {{surveyRequest.raters.length}}

{{Util.validateEmailCount(surveyRequest.emails, 2)}}


Step 5 - Review and Submit

When you hit the Submit button below, your request will be delivered to IDEA and you will be taken to a screen where you can review a summary of your request. A confirmation will be emailed to the primary contact listed on the request form. If there are any questions or concerns, IDEA Staff will follow-up with the primary contact.