1. Recognize and Report: Ethics and Standards for Reporting Child Abuse and Neglect in Georgia

We are pleased that you participated in a Foothills AHEC Healthtecdl educational program. Please take the time to fill out this evaluation survey, so that we can improve future programs.

For continuing education certificate, and/or certificate of completion, an evaluation is required. Continuing education certificates will be mailed to the participants.

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* 1. Please provide your name and email address so that we may identify registrants that complete the evaluation survey for continuing education certificates and/or certificates of completion. We will send reminder emails to those that do not complete the evaluation survey.

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* 2. Please indicate your professional degree.

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* 3. Name of Employer

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* 4. County Of Employment

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* 5. If you checked Social Worker please provide the last 4 digits of your SSN. Please indicate if your are MSW/ MFT/ LPC/ School Counselor/ or Other.

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* 6. If you checked Law Enforcement Personnel, please provide your Social Security number and type your name.

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* 7. If your are a student, please provide the name of your institution.

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* 8. Did you participate in the AHEC/Healthtecdl program from your organization's facilities?

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* 9. If yes, were there other individuals who viewed the presentation with you?

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* 10. If yes, number according to ethnicity

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* 11. If yes, number according to gender

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* 12. If yes, please provide the names and email addresses of these people, so we may have a complete record of participants.

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* 13. Please rate the following aspects of the program content:

  Strongly Disagree Disagree Neutral Agree Strongly Agree
Activity met the stated objectives.
Provide current statistics on the national and state level for child abuse and the impact of this crime.
Recognize four types of child maltreatment.
Review how to prepare a report of known or suspected child abuse.
Discuss how to promote protective factors to prevent abuse.

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* 14. How Would you rate the quality of instruction?

  Strongly Disagree Disagree Neutral Agree Strongly Agree
Instructional materials were well organized.
Instructional methods illustrated the concepts well.
If slides were presented, they will be useful reference.
References and resources provided will assist me.

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* 15. How would you rate the quality of the presentation?

  Strongly Disagree Disagree Neutral Agree Strongly Agree
Presenter was clear and to the point.
Presenter demonstrated mastery of the topic.
Methods used to present the materials held my attention.
Presenter was responsive to questions.

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* 16. Based on this activity, do you plan to make changes to your practice/organization?

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* 17. What one thing would you recommend that we change to improve content and/or presentation?

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* 18. Please rate the following aspects of the distance-based network.

  Very satisfied Satisfied Neutral Dissatisfied Very Dissatisfied
Ease of access to program.
Quality of the video/slides.
Quality of the audio.
Degree of interactivity.

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* 19. Please describe any difficulties that you encountered in participating in the program from your location.

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* 20. What one thing would you recommend that we change to the distance based aspect of the program?

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* 21. How did you hear about this program?

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