Assessment

Programs and services for children with hearing loss/deaf
Thank you for filling out our evaluation. It is anonymous and confidential. The results serve to improve the quality of our services.

Are you: *Mother/father/caregiver of a child with hearing loss/deafService provider of a child with hearing loss/deafPCANU Staff, Universal Neonatal Hearing Screening ProgramAPNI StaffStudentOther:

Specify:

Race *WhiteAfrican/AmericanNative AmericanTwo (2) or more racesNot disclosed

Ethnicity *Hispanic or LatinoNot Hispanic or LatinoNot disclosed

Age of the child with hearing loss

Town *

ZIP / Postal Code *

Housing Area *UrbanRural

Did the activity help me increase my knowledge, understanding and ability on the topic? *1 Poor2 Regular3 Good4 Excellent

The information received is useful in my personal and professional life. *1 Poor2 Regular3 Good4 Excellent

The resources showed mastery of the topic *1 Poor2 Regular3 Good4 Excellent

¿El material recibido ayudó a aumentar mis conocimientos? *1 Poor2 Regular3 Good4 Excellent

I can apply the information received to my situation *1 Poor2 Regular3 Good4 Excellent

Today I learned that:

La actividad estuvo: *ExcellentRegularIt fulfilled my expectationsIt didn't meet my expectations

What topics would you like us to discuss in future activities to benefit families and service providers of children with hearing loss/deaf?

Would you recommend our training to friends and family? *Please select an optionYeahNo

How did you find out about APNI services?

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Thank you