Perinatal Substance Abuse
Post Training Survey

Identifying Information

The Los Angeles Department of Children and Family Services (DCFS) and the University Consortium for Children and Families (UCCF) are interested the knowledge and skills you will learn (pre-assessment)/have learned (post-assessment), and your feedback regarding the quality of this training (post-assessment). This brief survey should take approximately 15 minutes to complete and will help us continue to provide high quality relevant training for you and your peers

Question Title

* If you would like to complete this survey online, please visit https://www.research.net/r/Perinatal-Post or point your smartphone camera or QR code reader at the QR code below.

Question Title

* What is today's date?

Date:

Date

Question Title

* In order to create an anonymous unique identification number for your response, please answer the following 4 questions.

What is your age (years)?

What month were you born (numeric-e.g., January = 1, February =2, etc.)?

What day of the month were you born (numeric)?

What are the last 2 digits of your phone number?

Question Title

* What is your Employee ID?

Question Title

* What is your name?

First

Last