Dream Big-GHW 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

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 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

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.