Module 4 Health Equity and Prevention Primer Survey

1. Note to CHES-certified participants: Prevention Institute is offering 5 Category I Continuing Education Contact Hours (CECH) for completing the Health Equity and Prevention Primer. Certified Health Education Specialists (CHES) must complete all seven modules.

Discontinue filling out this survey and fill out the CHES Assessment and Evaluation Survey instead at www.surveymonkey.com/s/BQRGBX9 to receive credit. This opportunity ends July 18, 2011!

Note to CHES-certified participants: Prevention Institute is offering 5 Category I Continuing Education Contact Hours (CECH) for completing the Health Equity and Prevention Primer. Certified Health Education Specialists (CHES) must complete all seven modules. Discontinue filling out this survey and fill out the CHES Assessment and Evaluation Survey instead at www.surveymonkey.com/s/BQRGBX9 to receive credit. This opportunity ends July 18, 2011!

2. Please provide some demographic information (optional):

Please provide some demographic information (optional): Name:
Organization:
City/Town:
State:
Email Address:
Phone Number:

3. What type of community or communities does your ogranization serve?

What type of community or communities does your ogranization serve? Urban

Rural

Suburban

Tribal

4. What is your job title?

What is your job title?

5. What type of organization do you work for?

What type of organization do you work for? Public Health Department

School

Non-profit

Other

If "other" please specify:

Module 4 Health Equity and Prevention Primer
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1. Demographic Information

Module 4 Health Equity and Prevention PrimerExit this survey

1. Demographic Information

Module 4 Health Equity and Prevention Primer
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