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A. Feedback on the ATMCH/MCH Navigator Webinar
Evaluate the following statements about the webinar.
Strongly Disagree
Disagree
Agree
Strongly Agree
The webinar was of high quality and was relevant to my work.
The webinar increased my knowledge of the topic.
The webinar increased my skills on the topic.
The webinar will be useful in my daily work.
The webinar was the appropriate level (not too basic or advanced).
Provide additional comments about this webinar.
What was particularly interesting and useful? What would you change?
B. Future Topics
Let us know what you would like to learn about in future ATMCH webinars.
C. User Information (Optional)
Which of the following best describes you?
Please select
State MCH/Title V agency staff
State Medicaid office
State governor's office/legislature
Local/community MCH professional
MCHB training grant - faculty member
MCHB training grant - student
Other HRSA-funded grant
Health provider/professional
Community-based/local organization staff
Family representative
Not-for-profit organization
Other, please specify below
Other
What state/territory do you work in/represent?
Please select
Alabama
American Samoa
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Marianas
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
What is your level of experience in MCH, broadly defined?
Please select
Relative "newbie"
Seasoned "vet"
Somewhere in the middle
None
What is the highest level of education you've received?
Please select
High school/some college
Bachelor's degree
More than a bachelor's degree
What is your age range?
Please select
Baby Boomer (1940s - mid 1960s)
Generation X (mid 1960s - early 1980s)
Generation Y (mid 1980s - 2000)
Millennial (2001 on)
Name
First
Last
Email