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MDoA’s Virtual Dementia Capability Training Post-Assessment
Post Assessment - Must be completed to receive a Certificate of Completion.
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* Indicates required question
Email
*
Your email
{{Name}}
*
Your answer
Agency/Organization
Your answer
Title
Your answer
Age
*
Choose
20 or below
21-59
60+
Prefer not to respond
Gender
*
Female
Male
Prefer not to respond
Other:
Race - select all that apply
*
American Indian/Alaska Native
Asian
Black or African American
Native Hawaiian/Pacfic Islander
White
Prefer not to respond
Other:
Required
Ethnicity
*
Choose
Hispanic
Non-Hispanic
Prefer not to respond
(Optional) Do you Identify as the following? - select all that apply.
*
Veteran
Family Caregiver
Person living with a disability
Person living with Dementia/Alzheimer's or related disorder
Professional working with individuals with Dementia/Alzheimer's or related disorders or their family caregivers
N/A
Required
Profession/Occupation
*
Choose
Information and referral providers, options counselors
Case managers, care coordinators, discharge planners
Other dementia-related program providers (e.g. caregiver skills trainers, support group facilitators, adult day services staff)
Direct care workers (e.g. certified nursing assistants, personal care attendants, companions)
Medical care providers (e.g. physicians, nurse practitioners, physicians assistants)
Allied health providers (e.g. occupational therapists, pharmacists, dietitians)
Volunteers (e.g. Meals on Wheels, friendly visitors)
First responders (paid and unpaid)
Legal professionals
Financial professionals (e.g. bank tellers, financial planners)
Community businesses (e.g. retail store employees, café baristas, hairdressers)
Clergy, other members of faith community
Students preparing for dementia-related work
Other
Prefer not to respond
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