Breathe/Refresher Pre-Training Assessment 2025-2027 Question Title * 1. Which Breathe training are you attending? Initial Breathe Training (1+ hour) Breathe Refresher (1 Hour) Question Title * 2. What is the format of the Breathe Training? In-Person Virtual Watched Recorded Training Question Title * 3. Date Breathe training is being held: Date Date Question Title * 4. What county is the Breathe training being held in? ADAM ALLEN BARTHOLOMEW BENTON BLACKFORD BOONE BROWN CARROLL CASS CLARK CLAY CLINTON CRAWFORD DAVIESS DEARBORN DECATUR DEKALB DELWARE DUBOIS ELKHART FAYETTE FLOYD FOUNTAIN FRANKLIN FULTON GIBSON GRANT GREENE HAMILTON HANCOCK HARRISON HENDRICKS HENRY HOWARD HUNTINGTON JACKSON JASPER JAY JEFFERSON JENNINGS JOHNSON KNOX KOSCIUSKO LAGRANGE LAKE LAPORTE LAWRENCE MADISON MARION MARSHALL MARTIN MIAMI MONROE MONTGOMERY MORGAN NEWTON NOBLE OHIO ORANGE OWEN PARKE PERRY PIKE PORTER POSEY PULASKI PUTNAM RENDOLPH RIPLEY RUSH ST. JOSEPH SCOTT SHELBY SPENCER STARKE STEUBEN SULLIVAN SWITZERLAND TIPPECANOE TIPTON UNION VANDERBURGH VERMILLION VIGO WABASH WARREN WARRICK WASHINGTON WAYNE WELLS WHITE WHITLEY Question Title * 5. Have you had any previous training on tobacco/smoking/vaping (including previous Breathe trainings)? Yes No Question Title * 6. How prepared do you feel to discuss SMOKING with parents/caregivers? Very prepared Somewhat prepared Neutral Not very prepared Extremely unprepared Question Title * 7. How prepared do you feel to discuss VAPING with parents/caregivers? Very prepared Somewhat prepared Neutral Not very prepared Extremely unprepared Question Title * 8. How prepared do you feel to discuss children's exposure to second and thirdhand smoke/vapor with parents/caregivers? Very prepared Somewhat prepared Neutral Not very prepared Extremely unprepared Question Title * 9. Have you ever shared smoking/vaping education or cessation resources with parents (including Breathe materials, if you were previously trained)? Check all that apply. Yes, many times Yes, a few times No, parents are not interested No, I do not have time No, I don't have opportunities to share resources No, I am uncomfortable sharing resources No, I do not know of any resources Question Title * 10. Do you have any questions about smoking/vaping? Or is there anything specific you hope to learn? Done