DMHA CLC Webinar 4 Survey

Question Title

* 1. Please enter your information

First Name

Last Name

Email Address

Organization

Job Title

County

Part 1: Evaluation survey

Please rate your level of agreement with each statement.

Question Title

* 2. Overall this video was a good use of my time.

Question Title

* 3. Which of the following are types of discrimination?

Homophobia

Transphobia

Biphobia

Racial Discrimination

Socioeconomic Status

Microaggressions

What are additional types of discrimination?

Question Title

* 4. I can define compounded discrimination.

Question Title

* 5. I can define mindfulness.

Question Title

* 6. I understand that intersectionality is the theory of how different types of discrimination interact and that people should be understood as more than just one label.

Question Title

* 7. I would recommend this webinar to my colleagues.

Question Title

* 8. Please choose the group you represent:

Community Mental Health Center

System of Care

Treatment Provider

Recovery Community

Indiana State Agency

Other

Question Title

* 9. In the group selected above, I have_____years of experience in my current or multiple roles.

Question Title

* 10. Does your patient population include Indigenous people?

Yes

I don't know

N/A, my organization does not provide clinical services or direct community services.

DMHA CLC Webinar 4 Survey

Question Title

* 1. Please enter your information

Question Title

* 2. Overall this video was a good use of my time.

Question Title

* 3. Which of the following are types of discrimination?

Question Title

* 4. I can define compounded discrimination.

Question Title

* 5. I can define mindfulness.

Question Title

* 6. I understand that intersectionality is the theory of how different types of discrimination interact and that people should be understood as more than just one label.

Question Title

* 7. I would recommend this webinar to my colleagues.

Question Title

* 8. Please choose the group you represent:

Question Title

* 9. In the group selected above, I have_____years of experience in my current or multiple roles.

Question Title

* 10. Does your patient population include Indigenous people?

Question Title

* 11. What Indiana county(ies) do you represent?

Question Title

* 12. Additional Comments/Feedback/Questions: