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We would love to hear from you!

Your feedback is incredibly valuable so that we may provide the best possible experience for future Be a Part of the Conversation online programs. The survey should take less than five minutes to complete. Thank you in advance for completing this survey!
Your responses are completely anonymous.
By participating in this survey you understand and agree that some overall results and some open-ended remarks may be shared for administrative or marketing purposes.

Our Mission
Be a Part of the Conversation addresses substance use, misuse and addiction and its impact on individuals and their families by building a culture of awareness and support.

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* 1. Please provide the date or name of the online program for which you are providing feedback:

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* 2. What is your gender? You can choose multiple options.

Female

Male

Nonbinary or Genderqueer

Decline to State

Different Identity

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* 3. Which race/ethnicity best describes you? (Please choose only one.)

American Indian or Alaskan Native

Asian / Pacific Islander

Black or African American

Hispanic

White / Caucasian

Prefer not to say

Multiple ethnicity / Other (please specify)

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* 4. Age

Under 18

18-25

26-45

46-65

66+

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* 5. How many Be a Part of the Conversation programs (whether in-person or online) have you attended?

This is my first

2 to 5

5 or more

I'm not sure

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* 6. What brought you to this program? (check all that apply)

General Interest

I want to learn about the prevention of substance use and/or addiction.

Professional Interest (Medical/Health Care)

Professional Interest (Treatment/Therapeutic)

I am concerned about someone who is struggling with substance use.

I know someone who is currently in recovery from a substance use disorder/addiction.

I am currently struggling with substance use.

I am currently in recovery from a substance use disorder/addiction.

Other (please specify)

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* 7. Did you find this presentation helpful?

Very helpful

Somewhat helpful

Not very helpful

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* 8. What did you hear at this program that was particularly helpful?

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* 9. Before this program, how did you feel about the topic presented?

	Not at all	Slightly	Quite	Extremely
Knowledgeable	Knowledgeable Not at all	Knowledgeable Slightly	Knowledgeable Quite	Knowledgeable Extremely
Aware of Resources	Aware of Resources Not at all	Aware of Resources Slightly	Aware of Resources Quite	Aware of Resources Extremely

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* 10. After this program, how do you feel about the topic presented?

	Not at all	Slightly	Quite	Extremely
Knowledgeable	Knowledgeable Not at all	Knowledgeable Slightly	Knowledgeable Quite	Knowledgeable Extremely
Aware of Resources	Aware of Resources Not at all	Aware of Resources Slightly	Aware of Resources Quite	Aware of Resources Extremely

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* 11. Which of the following topics would you like us to present in the future? (check as many as you like)

Setting Healthy Boundaries

Technology & Youth

Isolation in the time of COVID-19

Underage Drinking

Addiction 101

Marijuana

Vaping / Electronic Cigarettes

Prescription Drug Misuse / Addiction

Pathways to Recovery

Experts in the Field of Addiction

Other (please specify)

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* 12. Would you recommend a Be a Part of the Conversation program to a friend?

Yes

Maybe

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* 13. Would you participate in a Be a Part of the Conversation program in the future?

Yes

Maybe

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* 14. Please share any additional feedback.

Be a Part of the Conversation is a 501(c)3 nonprofit organization.

Click here if you would like to make a tax deductible contribution.

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If you are interested in volunteering, please send an email to info@conversation.zone

Visit our website to learn more: www.conversation.zone

Thank you, and take good care of yourself!
We sincerely appreciate your feedback.