Engaging Your Community: Pre-Module Knowledge Assessment Survey

Department of Health and Human Services, Office of Adolescent Health

Pre-Module Knowledge Assessment Survey for Engaging Your Community: A Toolkit for Partnership, Collaboration, and Action

The purpose of this survey is to assess your current knowledge and comfort with engaging your community in partnerships, collaboration and action. The survey results will be used to improve the Toolkit.

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* 1. Please indicate your program type:

AFL Care Demonstration Project

OAH Grantee

Other (please specify):

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* 2. What is your current position? Please mark all that apply.

Manager/Administrator

Health Care Provider

Health Educator

Social Worker

Program Evaluator/Researcher

Trainer

Federal Staff

Other (please specify)

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* 3. In which State or U.S. Territory do you work?

State:

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* 4. Have you heard of Engaging Your Community: A Toolkit for Partnership, Collaboration, and Action before?

Yes (If Yes, please specify where):

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* 5. Have you previously used the information from Engaging Your Community: A Toolkit for Partnership, Collaboration, and Action?

Yes (If yes, please specify how):