Module 3 Pre-Tests and Surveys

Module 3:

How to Debunk Misinformation and Bolster Vaccine Confidence

PRE-course Survey Questions

Please take this prior to viewing the presention.

Date*

Date

Enter Full Name*

Zip Code*

Email*

example@example.com

Yes, I am a Community Health Worker/PromotorYes, I am a CHW instructor.I am not a Community Health Worker/Promotor(a)or a CHW instructor. Just here to learn!

YesNoUnsure

OPTIONAL: If so, how?

On a scale of 1 (not at all confident) to 10 (very confident), how confident are you in your ability to talk about vaccines with others in your community?*

OPTIONAL: What type(s) of communities do you serve?