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Healthy Native Youth Feedback Form

Thank you! Many thanks for requesting technical assistance, attending our training, and/or participating in our Community of Practice. We would like to hear whether it was helpful for you, and how we can support other trainees or interested educators. We appreciate your feedback!

The survey will take approximately 10 minutes to complete.
1.First and Last Name: (optional)
2.Tribe or Organization: (Required.)
3.What state do you live in?
4.If you live outside the U.S., what country do you live in?
5.Phone or Cell Phone:
6.What is your email address:
7.What Healthy Native Youth (HNY) activity did you participate in? (select all that apply)
8.How likely are you to use the information you acquired from the website, during the training, and/or from the TA we provided?
9.How would you rate the quality of the curriculum, training, and/or technical assistance (TA) that you received from Healthy Native Youth?
0 - Poor
Neutral
10 - Excellent
10.How would you rate the cultural-relevance and/or fit of the curriculum, training, and/or TA that you received from Healthy Native Youth?
0 - Poor
Neutral
10 - Excellent
11.How were the materials received by your students and/or community partners?
0 - Not well received
Neutral
10 - Very well received
12.What impact has the Healthy Native Youth’s website, trainings, and/or other resources had on you and your community? (check all that apply)
13.In the last year, have you implemented any HNY curricula? (check all that apply)
14.If yes, how many students attended the program:
15.Where have you used HNY’s curricula, lesson plans, and/or Implementation Toolbox templates? (check all that apply)
16.Did you make any changes, enhancements, or adaptations to the materials?
17.As you think about the phases in the HNY Implementation Toolbox, what phase most closely describes the type of work you are doing right now?
18.In the last year, have you used any of HNY’s Implementation Toolbox tools or templates? (check all that apply)
19.Do you have any additional feedback or changes you would recommend to help improve the HNY website, technical assistance, templates, or trainings?
20.Do you have a quote or story to share? Do you have a reflection, memory, or story about the HNY website and its resources? Please share your reflection/memory in the box below.

For Example: What makes HNY stand out as a resource? What do people need to know about HNY? What difference has the HNY website and TA made to your work?

We love to share quotes from those who have successfully used the HNY website or its resources.
21.May we share your feedback on the www.HealthyNativeYouth.org website?
Thanks for all that you do to raise Healthy Native Youth!