DFW AHEC Follow Up

The DFW Area Health Education Center (AHEC) is a community-based health workforce development organization. We are following-up on former participants of AHEC programs and AHEC Partner programs to see how they are progressing in their education or career.

We would love to have information on you! The information we collect will help us to determine our effectiveness and will only be used internally.

1. In which AHEC Program(s) did you participate?

In which AHEC Program(s) did you participate? FIRST CHOICE-NURSING

NURSING E-Mentoring

NURSING LOAN PROGRAM

PIONEERING NURSINGS FUTURE: EXCELLENCE THROUGH DIVERSITY

DFW AHEC Middle School Mentorship Program at Dunbar 6th

DFW AHEC Middle School Mentorship Program at JP Elder

DFW AHEC Middle School Mentorship Program at Zumwalt

DFW AHEC Middle School Mentorship Program at Thomas Edison

COMMUNITY-BASED CLINICAL ROTATION

OTHER COLLEGE INTERNSHIP

EXPLORER POST

CAMP MED

CAMP NURSE

HEALTH CAREERS PRESENTATION

Other AHEC PROGRAM (please list)

2. If you participated in a COMMUNITY-BASED CLINICAL ROTATION, please list the school you were enrolled in at the time.

If you participated in a COMMUNITY-BASED CLINICAL ROTATION, please list the school you were enrolled in at the time.

3. What year(s) did you particpate in the above program(s)?

What year(s) did you particpate in the above program(s)?

4. Have you graduated from high school?

Have you graduated from high school? If YES, What year did you graduate?
If NO, When do you expect to graduate?
If DROP OUT, What was the primary reason?

5. Are you currently enrolled in college or technical school?

Are you currently enrolled in college or technical school? If YES, Which School?
If NO, Do you have plans to go to college?

6. Are you currently enrolled in a health professions program or pre-health professions program?

Are you currently enrolled in a health professions program or pre-health professions program? YES

If YES, Which program are you pursuing?

7. Have you completed a health professions program or training?

Have you completed a health professions program or training? YES

8. When did you finish or do you expect to finish the health professions program/training?

When did you finish or do you expect to finish the health professions program/training?

9. Where do you or think you might want to work/practice after completing the health professions program/training?

Where do you or think you might want to work/practice after completing the health professions program/training?

10. Are you currently working in health care?

Are you currently working in health care? YES

11. If you answered Yes to currently working in Healthcare, answer these three questions.

If you answered Yes to currently working in Healthcare, answer these three questions. Where are you working?
Does the organization/company serve 50% or more of the underserved populations?
What is your job title?

12. If you answered No to currently working in healthcare, are you currently looking for work?

If you answered No to currently working in healthcare, are you currently looking for work? Yes

13. May we get some updated information from you? We will not share this information with anyone else.

May we get some updated information from you? We will not share this information with anyone else. Name
Birthday
Ethnicity
Mailing Address
Phone
Email

14. Is it ok, if we send you information from time to time on our programs?

Is it ok, if we send you information from time to time on our programs? Yes

15. This question regards the AHEC program which you participated in. How influential would you say it was in your career path? Would you say it was:

This question regards the AHEC program which you participated in. How influential would you say it was in your career path? Would you say it was: Not at all influential

Somewhat influential

Very influential

16. Please give any comments that you deem are important and beneficial to AHEC about any of their programs or partner's programs.

Please give any comments that you deem are important and beneficial to AHEC about any of their programs or partner's programs.

Thank you so much for answering these questions!
Please contact us at 214-648-8340 if you feel we may be of some assistance in some way with your health career goals!

www.dfwahec.org

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