Trauma Informed Care Trainings Survey Dear TIC Trainer- Below you will find a brief survey asking you details about the training you completed. Please fill out the survey each time you provide a new training on Trauma Informed Care. This survey will provide the Ohio Department of Mental Health and Addiction Services and the Ohio Department of Developmental Disabilities with information about the need for and response to Trauma Informed Care training being offered throughout Ohio. Thank you for your time and participation. Your input is valuable and appreciated. Question Title * 1. Name of Trainer Question Title * 2. Email Address Question Title * 3. Phone Number Question Title * 4. Agency/Organization Trained Question Title * 5. County Location of Organization Trained Question Title * 6. Date of Training Date: Date Question Title * 7. Populations Served of those trained (please write in number of attendees that specialize with each population) Early Childhood Mental Health-Adult Mental Health-Child/Adolescent Substance Abuse-Adult Substance Abuse-Child/Adolescent Developmental Disabilities Child Welfare Juvenile Justice Aging Domestic Violence Veterans/Military LGBTQ Human Trafficking Adult Criminal Justice Juvenile Justice Local Health Departments Schools Question Title * 8. Attendees Field of Practice (please write in number of attendees in each field) Early Childhood Behavioral Health Psychology Social Work Psychiatry Counseling Nursing Dieticians Doctors (MD, DO) Health Educators Sanitarians Peer Specialist Direct Care Provider Question Title * 9. Number of Staff Trained Question Title * 10. Do you think Medical Doctors or Doctors of Osteopathy (MD/DO) would attend any local trainings? Yes No Thank you for participating in our survey! Done