This evaluation must be completed to receive 1.0 contact hours for CTLE or CBIS. Certificates will be emailed within a week of completion of the evaluation.  

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* 1. What is your name? (First, MI, Last)

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* 2. What is your email address?

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* 3. What is your school or school district?

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* 4. What type of certificate are you requesting?

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* 5. What are the last four digits of your social security number?  (Required if you are requesting CTLE)

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* 6. What is your date of birth? (mm/dd/yyyy)-  (Required if you are requesting CTLE)

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* 7. What is your position in your school district?

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* 8. Did the presentation meet the stated objectives?  

Attendees will: 
  • Appreciate the challenges of a concussed student
  • Be able to identify causes of a concussion 
  • Recognize symptoms of a concussion they may see in a student
  • Understand the purpose of a concussion management team
  • Learn a variety of adjustments/ accommodations for working with a    concussed student

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* 10. Please rate the following statements.

  Strongly Agree Agree Neutral Disagree Strongly Disagree
The presentation changed how I will deal with concussed students in the future.
The presenter was knowledgeable.
The teaching methods used during the presentation were effective.
The presentation was organized and easy to follow.
The presenter was well prepared.

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* 11. Have you ever been involved in advocating for a change in a statewide policy?

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* 12. Please rate the following statements.

  Strongly Agree Agree Neutral Disagree Strongly Disagree
Concussion management teams should be required at all schools in New York State.
A formal Return to Learn protocol should be required for all schools in New York State.
All non-public schools in New York State should follow the same concussion rules as public schools.
Return to Learn training like this presentation should be required for all teachers in New York State.

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* 13. Please use this space to provide any additional suggestions or comments about the presentation.

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* 14. Funding related to this presentation allows us to send you a resource folder about concussions in the classroom.  If you would like a folder please supply your mailing address.

0 of 14 answered
 

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