Please answer the questions below.

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* 1. Please check the box that best describes your organization:

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* 2. Which module are you evaluating?

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* 3. Please identify how long you have been working in the listed fields:

  Less than 1 year 1 - 5 years 6 - 10 years More than 10 years N/A
Domestic abuse
Sexual abuse
Elder abuse

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* 4. The content in this module is relevant to my job.

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* 5. This module gave me some good ideas on how to improve services to abuse in later life survivors in my community.

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* 6. The worksheet that accompanied this training module offered practical tips and action strategies.

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* 7. As a result of this training module and worksheet, I will:

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* 8. I would recommend the Abuse in Later Life Education Series for Advocates to others:

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* 9. If you are interested in receiving more information, please check all that apply:

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* 10. If you checked any of the boxes above, please add your contact information below:

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* 11. Use this space to provide additional comments/suggestions you would like to share with us.

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