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* 1. How did you hear about our teach-back program materials?

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* 2. How do you plan to use or how did you use the program materials?

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* 3. How would you rate the overall usefulness of this program?

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* 4. What resource/tool was most useful to you?

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* 5. How likely are you to recommend this program to someone else?

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* 6. Do you have any suggestions for how we could improve this program?

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* 7. Please provide the following demographic information.

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* 8. Would you like to be contacted about your answers by a representative from the Minnesota Health Literacy Partnership?

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* 9. May we use the information you provided in further promotion of our program? (For example, quote on website, acknowledge use of program, share with other users of program materials.)

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