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* 1. What state are you from?


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* 2. What organization do you work for?

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* 3. What is your position

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* 4. My knowledge of developmental milestones has increased after taking this course.

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* 5. This training has helped me to feel more comfortable asking families to complete a milestone checklist and reviewing it briefly with them.

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* 6. Will you use the “Learn the Signs. Act Early.” resources mentioned in the course to help WIC families monitor the development of their children?

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* 7. The amount of information presented and the time it took for the module was appropriate.
 


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* 8. How did you hear about this module?

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* 9. Would you like to be contacted to share more about your experience with the WIC Developmental Monitoring Program? If yes, please share your contact information.


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