Module 4 Post-Tests and Surveys

Module 4:

Barriers to Vaccination and Navigating People to Vaccine Services

POST-course Survey Questions

Please take this prior to viewing the presention.

Date*

Date

Enter Full Name*

Email*

example@example.com

Zip Code

Address: (Must have for gift card)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Did this training increase your confidence in your ability to talk about vaccines with others in your community?*

YesNoUnsure

Did this training increase your confidence in your ability to talk aboutvaccines with others in your community?*

YesNoUnsure

OPTIONAL, If Yes, how so?

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?*

Did this training increase your confidence in your ability to navigate people to vaccination services?

YesNoUnsure

Did this training increase your confidence in your ability to navigate people to vaccination services?*

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 connect people to vaccine services?*

Did this class increase your knowledge about vaccina>on services for thosewith and without health insurance?

YesNo

What did you think about the LENGTH of this course?*

Too LongToo ShortThe Length was adequate

What did you think about the AMOUNT OF CONTENT INCLUDED in this course?*

Too MuchNot EnoughThe amount of content was adequate

Do you expect to use the information you learned during this course?

YesNoUnsure

Optional: if Yes, How

OPTIONAL: Please share any opinions/comments about the class andhow it might be improved.