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F2022 PPED YouTube Survey

HSS Education Institute Videos

Please fill out this survey to assist us with improving HSS education programs. Completing this survey is voluntary and does not affect your participation in any other programs or the care HSS provides for you. Your responses are confidential and will only be seen by project staff to report results in aggregate form (e.g. averages). Thank you for your help!

Please tell us about your experience in HSS-sponsored programs by providing your level of agreement to the statements below:

1. Overall, I am satisfied with this video:

Please explain:

2. I would recommend this video to others (e.g. family, friends, colleagues):

Please explain:

3. Today's video has increased my understanding of my health:

Please explain:

4. As a result of today's video, I can apply what I have learned to manage my health:

Please explain:

Please tell us about you and your background so that we can learn more about the communities we serve:

5. Gender Identity:

Please enter an 'other' value for this selection.

6. Age

7. Do you consider yourself Hispanic/Latino?

8. Which one or more of the following would you say is your race? (Check all that apply)

American Indian or Alaska Native
Asian
Black or African American
Hawaiian or Pacific Islander
White / Caucasian
Some other race(s): Please enter an 'other' value for this selection.

9. Please tell us your ethnicity; you can list as many as your prefer (for example: Chinese, Nigerian, Italian, Puerto Rican, Russian, etc.)

10. Where do you currently live?

Country

State

City

Zip Code