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1. Name:

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2. Name of Community:

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3. Email Address:

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4. Do you use a specific program or manual to train new med techs/aides? If so...what program is your community utilizing to train your Med Techs/Aides?

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5. Is it online, in-person, or a combination?

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6. How long does the training take?

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7. Do you teach it all at one time or break it into segments?

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8. What would you like to change about your current training program?

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9. If you currently utilize HCAM’s Medication Management training program, how are you specifically implementing the program? i.e. what parts of the program do you utilize?, what chapters do you teach?, etc.

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11. Would you prefer HCAM to offer the Train-the-Trainer program

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12. Are you interested in an online program that would directly teach the medication aides? If so, would you prefer

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