3.1.16 NSSI Webinar Feedback Form

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* 1. Name:

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* 2. Organization:

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* 3. Email:

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* 4. On a scale of 1 to 5 how relevant was this webinar to the work that you do? 1 being very unhelpful and 5 being very helpful.

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* 5. On a scale of 1 to 5 how much of the information presented today was unknown to you before? 1 being nothing was new and 5 being everything was new.

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* 6. On a scale of 1 to 5 how likely are you to register for future webinars hosted by Screening for Mental Health? 1 being very unlikely and 5 being very likely.

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* 7. On a scale of 1 to 5 how likely are you to share the information from today's webinar with your coworkers? 1 being very unlikely and 5 being very likely.

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* 8. If you answered you were unlikely to share the information that you learned with your coworkers, please explain.

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* 9. Is there a topic you would like covered in a future webinar?

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* 10. Please add any additional feedback

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* 11. Please leave your email address if you are interested in receiving our quarterly E-Newsletters 

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