County Health Department Survey Thanks for taking our survey so we can respond to your community's needs. Question Title * 1. Name of County OK Question Title * 2. Name of Health Educator (or other contact with title) OK Question Title * 3. Phone OK Question Title * 4. Email Address: OK Question Title * 5. Does your HD use any UNYPC poison prevention materials? Yes No Don't know OK Question Title * 6. If Yes, please check all that apply. Magnets Stickers Stop Ask First Video Teacher's Guide Other (please specify) OK Question Title * 7. Do you download any materials from the UNYPCC website? Yes No OK Question Title * 8. If NO, please select all reasons why not Do not know about programs/materials offered Know about the programs/materials but haven't used them Have used a program or materials but not recently Not interested in the programs and materials Other (please specify) OK Question Title * 9. What might encourage you to use the UNYPC poison prevention materials? I would like an easy way to learn about the programs and materials I would like to talk to a poison center educator about ideas for getting started in our community I will go online at www.upstatepoison.org for some ideas I am not interested OK Question Title * 10. Would you be interested in attending a webinar to learn more about the UNYPC programs and materials? Yes No Maybe OK Question Title * 11. Please select from the list, any of the groups you interact with Elementary Schools Health Clinics Neighborhood Centers Pediatricians/Family Medicine Physicians Head Starts Other (please specify) OK Question Title * 12. Please list any idea you might have for collaborating with the UNYPC on a poison safety project. OK DONE