Toolbox Feedback: Improving the Receipt
of Clinical Preventive Services among Women with Disabilities

AMCHP is very interested in hearing from you regarding your use and experience with the online Toolbox for "Improving the Receipt of Clinical Preventive Services among Women with Disabilities."

Please take a few minutes to complete the survey. Your feedback is very important to maintaining and improving this resource in the future.

Question Title

* 1. Overall, I am very satisfied with the information and resources available in the “Improving the Receipt of Clinical Preventive Services among Women with Disabilities" Toolbox.

Strongly Agree

Agree

Neither agree nor disagree

Disagree

Strongly Disagree

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* 2. The information and resources in the Toolbox are relevant to my professional needs.

Strongly Agree

Agree

Neither agree nor disagree

Disagree

Strongly Disagree

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* 3. Did you use any of the tools in your work?

Yes

No

Question Title

* 4. If yes, please briefly describe how you used the tools:

Tool/s used:

How tool/s was/were used:

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* 5. Would you recommend any other tools be included in the Toolbox?

Yes

Not at this time

If yes, please list and provide contact information if possible:

Question Title

* 6. Please list any additional comments: