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We would love to hear from you!
Your feedback is incredibly valuable so that we may provide the best possible experience at future Be a Part of the Conversation events. The survey should take
less than five minutes
to complete. Thank you in advance for completing this survey!
Your responses are completely anonymous.
By participating in this survey you understand and agree that some overall results and some open-ended remarks may be shared for administrative or marketing purposes.
Our Mission
Be a Part of the Conversation addresses substance use, misuse and addiction and its impact on individuals and their families by building a culture of awareness and support.
1.
Gender
Female
Male
Other
2.
Which race/ethnicity best describes you? (Please choose only one.)
American Indian or Alaskan Native
Asian / Pacific Islander
Black or African American
Hispanic
White / Caucasian
Prefer not to say
Multiple ethnicity / Other (please specify)
3.
Age
Under 18
18-25
26-45
46-65
66+
4.
How many
Be a Part of the Conversation
programs have you attended?
This is my first
2 to 5
5 or more
I'm not sure
5.
What brought you to this event? (check all that apply)
General Interest
I want to learn about the prevention of substance use and/or addiction.
Professional Interest (Education)
Professional Interest (Treatment/Therapeutic)
I am concerned about someone who is struggling with substance use.
I know someone who is currently in recovery from a substance use disorder/addiction.
I am currently struggling with substance use.
I am currently in recovery from a substance use disorder/addiction.
Other (please specify)
6.
Are you a K through 12 parent, educator, or student? (check all that apply)
K through Grade 5
Grade 6 - 8
Grade 9 - 12
I am a K-12 parent.
K through Grade 5
Grade 6 - 8
Grade 9 - 12
I am a K-12 educator.
K through Grade 5
Grade 6 - 8
Grade 9 - 12
I am a K-12 student.
K through Grade 5
Grade 6 - 8
Grade 9 - 12
If you checked any of the above, what is the name of the school or school district?
7.
Did you find this presentation helpful?
Very helpful
Somewhat helpful
Not very helpful
What did you hear that was particularly helpful?
8.
If you are a parent, how likely are you to initiate a conversation with your child regarding the topic presented at this event?
Not at all
Slightly
Quite
Extremely
What did you hear that will help you to have that conversation? Or, what additional information would have been helpful?
9.
Before
attending this event, how did you feel about the topic presented?
Not at all
Slightly
Quite
Extremely
Knowledgeable
Not at all
Slightly
Quite
Extremely
Aware of Resources
Not at all
Slightly
Quite
Extremely
10.
After
attending this event, how do you feel about the topic presented?
Not at all
Slightly
Quite
Extremely
Knowledgeable
Not at all
Slightly
Quite
Extremely
Aware of Resources
Not at all
Slightly
Quite
Extremely
11.
Which of the following topics would you like us to present in the future? (check as many as you like)
Setting Healthy Boundaries
Technology & Youth
Underage Drinking
Marijuana
Vaping / Electronic Cigarettes
Family Dynamics
Young People in Recovery from Alcoholism or Addiction
Family Members Impacted by Alcoholism or Addiction
School In-service Day or other Professional Development
"Mock Teen Bedroom" (showing indications of substance use)
Experts in the Field of Addiction
Other (please specify)
12.
Would you recommend a Be a Part of the Conversation program to a friend?
Yes
Maybe
No
13.
Would you attend a Be a Part of the Conversation program in the future?
Yes
Maybe
No
14.
Please share any additional feedback.
Be a Part of the Conversation is a 501(c)3 nonprofit organization.
Click here if you would like to make a tax deductible contribution.
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If you are interested in volunteering, please send an email to
info@conversation.zone
Visit our website to learn more:
www.conversation.zone
Thank you!
We sincerely appreciate your feedback!
